Posted by STEAM PROJECT
My STEAM project is about atrial fibrillation with rapid ventricular response (Afib with RVR). The main course objectives that I will be covering are identifying the various components of blood and key structural components, describing how the human body binds and releases O2 and CO2, Explaining how the heart translates an electrical signal to a contraction, Explaining how the heart is regulated, Explaining the structure and function of the heart, Describing how respiration is regulated, and Analyzing the interaction of the cardiac and respiratory system.. I drew a board with a normal sinus rhythm and different types of atrial dysrhythmias.
Afib with RVR is an irregular heart rhythm that can lead to many things, “including stroke, heart failure, and even death” (Long et al., 2023). In the United States, nearly two million adults suffer from Afib. Afib is one of the most common dysrhythmias in adults, and with age comes a higher risk of developing it (Cleveland Clinic, 2023). As a young adult who has personally dealt with Afib with RVR, I can say that it is a stressful and scary thing to deal with.
There are many types of Afib, including Afib with normal ventricular response, Afib with bradycardia (pulse <60), and Afib with rapid ventricular response. For this project, however, I will be doing a deep dive into Afib with RVR.
The first thing I would like to go over is the structure and the blood flow throughout the heart. The heart is broken up into four chambers, each of which acts as a mini pump inside the heart. The two top chambers are called the atria, and they are responsible for filling the ventricles (the bottom two chambers) with blood to be pumped to various areas around the body. The right side of the heart is responsible for pumping deoxygenated blood to the lungs. First, the blood that has been transported around the body (has used up its oxygen and is now carrying carbon dioxide to the lungs to be exhaled) enters through the superior and inferior vena cava into the right atrium. It is then pumped through the tricuspid valve into the right ventricle. From there, the deoxygenated blood flows through the pulmonary valve into the pulmonary artery and then makes its way to the alveolar capillaries and, through respiration, becomes oxygenated and then heads over to the left atrium through the pulmonary veins (the pulmonary veins are the only veins that carry oxygenated blood in the entire body). The blood then moves from the left atrium through the bicuspid valve into the left ventricle. The blood is then pumped from the left ventricle into the aorta, which carries oxygenated blood to the entire body.
The next topic I need to address is how electricity is supposed to move throughout the heart. First, the brain stimulates the sinoatrial node (SA node), which is located in a “special tissue” in the right atrium, to generate an electrical impulse that is sent to the atrioventricular node (AV node). During the brief pause when the electrical signal from the SA node is being sent to the AV node, the atria contract, forcing blood into the ventricles. After the AV node has received the electrical signal, it sends the electrical impulse through the bundle of His. The electrical impulse is then transported through the bundle of His into the Purkinje fibers. When the Purkinje fibers receive the electrical impulse, they then cause the ventricles to contract, sending blood to various parts of the body (Cleveland Clinic, 2021).
So now that we have learned how the heart functions, how does this have to do with Afib with RVR? Atrial fibrillation occurs when the SA node is not functioning properly. In Afib, electrical impulses are generated somewhere besides the SA node in the atrium; it can also be caused by the electrical path being different than normal. This causes the atria to go into a seizure-like state (fibrillation) (Department of Cardiology Royal Melbourne Hospital, n.d.). On an electrocardiogram (ECG), Afib is seen with the absence of a P wave. A P wave on an ECG shows the electrical impulse (or depolarization of the atria) that allows the atrium to contract. The problem with Afib is that when the atrium is not contracting properly blood flow through the body slows and oxygenation of the red blood cells decreases. This prohibits proper perfusion in tissues throughout the body which can cause “pain, numbness, tingling or [a] cold [sensation]” (Cleveland Clinic, 2021b). Afib with RVR happens when the ventricles contract rapidly during the Afib episode.
Treatments for Afib RVR include cardioversion and/or (medication metoprolol, diltiazem, and amiodarone) (Moskowitz et al., 2017). I personally have been cardioverted twice (both in the emergency department at Fairbanks Memorial hospital) I have been prescribed metoprolol for my afib RVR by my cardiologist. Ablation is a long term fix for Afib. “[Ablation] uses small burns or freezes heart cells to cause some scarring on the inside of the heart. This helps break up or insulate the electrical signals that cause irregular heartbeats. This can help the heart maintain a normal heart rhythm ”
References
Cleveland Clinic. (2021a). Heart Conduction: What Is It & How It Works. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21648-heart-conduction-system
Cleveland Clinic. (2021b, September 27). Poor Circulation: Symptoms, Causes and Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21882-poor-circulation
Cleveland clinic. (2023, January 6). What is A-fib with RVR? Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24578-atrial-fibrillation-with-rvr
Department of Cardiology Royal Melbourne Hospital. (n.d.). Atrial Fibrillation: Pacemaker and AV Node Ablation – Melbourne Heart Rhythm. Www.melbourneheartrhythm.com.au. Retrieved April 17, 2025, from https://www.melbourneheartrhythm.com.au/learn/procedures/14-av-node-ablation-and-pacing
Johns Hopkins Medical. (n.d.). Atrial Fibrillation Ablation. Www.hopkinsmedicine.org. Retrieved April 17, 2025, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/atrial-fibrillation-ablation
Long, B., Brady, W. J., & Gottlieb, M. (2023). Emergency medicine updates: Atrial fibrillation with rapid ventricular response. American Journal of Emergency Medicine, 74(28), 57–64. ScienceDirect. https://doi.org/10.1016/j.ajem.2023.09.012
Moskowitz, A., Chen, K. P., Cooper, A. Z., Chahin, A., Ghassemi, M. M., & Celi, L. A. (2017). Management of Atrial Fibrillation with Rapid Ventricular Response in the Intensive Care Unit. SHOCK, 48(4), 436–440. https://doi.org/10.1097/shk.0000000000000869
Photos of me working on my project are below.
Sağlamol, G., Taşkın, Ö., & Akpınar, A. (2021). Etiology and mortality markers in atrial fibrillation with rapid ventricular response Hızlı ventrikül yanıtlı atriyal fibrilasyonun nedenleri ve mortalite belirteçleri. Cukurova Medical Journal Cukurova Med J, 46(1), 160–165. https://doi.org/10.17826/cumj.790528
This person created their steam project on AFIB with RVR (atrial fibrillation with rapid ventricular response). This is a dysrhythmia which is the most common type of abnormality in cardiac rhythm. This abnormality can have negative effects like heart failure, stroke, pain, numbness, and death. This is also something the author is dealing with himself, so that is scary, but grateful that he can share that with us. This also goes to show that young adults can have this, and not just older people. The physiological part of AFRIB RVR is when the SA node is not functioning properly, and the electrical impulse is being transport to a different path causing something seizure like. The author did a great job with describing into detail about AFIB RVR, and I think that he did an awesome job with his project.