Differential Diagnosis for Afib with RVR with Pauses and Rates 130s

• Single most likely diagnosis:
  • Atrial Fibrillation with Rapid Ventricular Response (RVR) and pauses: This is the most likely diagnosis given the symptoms. Afib with RVR can cause irregular heart rates, and pauses can occur due to the irregularity of the ventricular response.
• Other Likely diagnoses:
  • Multifocal Atrial Tachycardia (MAT): This condition can mimic Afib with RVR and may cause similar symptoms, including irregular heart rates and pauses.
  • Atrial Flutter with Variable Block: Atrial flutter can cause rapid ventricular rates, and variable block can lead to pauses and irregular heart rhythms.
  • Sinus Tachycardia with Premature Atrial Contractions (PACs): PACs can cause irregular heart rhythms and pauses, especially if they are frequent.
• Do Not Miss diagnoses:
  • Wolff-Parkinson-White (WPW) Syndrome: This condition can cause Afib with RVR and is a medical emergency if not treated promptly. WPW syndrome can lead to life-threatening arrhythmias.
  • Cardiac Tamponade: Although less likely, cardiac tamponade can cause Afib with RVR and pauses due to the decreased cardiac output and increased pressure on the heart.
  • Pulmonary Embolism: A large pulmonary embolism can cause Afib with RVR and pauses due to the increased pressure on the right ventricle.
• Rare diagnoses:
  • Junctional Tachycardia: This is a rare condition that can cause rapid ventricular rates and pauses.
  • Idiopathic Ventricular Tachycardia: Although rare, this condition can cause rapid ventricular rates and pauses, especially in young individuals with no underlying heart disease.
  • Hyperkalemia-induced Arrhythmia: Severe hyperkalemia can cause various arrhythmias, including Afib with RVR and pauses.