Atrial fibrillation is a heart rhythm disorder that affects millions of people. It can make you feel lousy. Even worse, it can cause potentially disabling or deadly strokes. A special MRI scan may — I stress the “may” — help identify people with atrial fibrillation who are at high risk of having a stroke. This could help many people with this condition to avoid taking warfarin or other clot-preventing medications for life.
A normal heartbeat starts in a cluster of cells called the pacemaker. It sits in the heart’s upper right chamber (the right atrium). These cells generate a pulse of electricity that flows to the rest of the heart and causes a coordinated heartbeat. In people with atrial fibrillation, electrical signals arise from areas outside of the pacemaker. These signals are fast and irregular. So instead of contracting with a steady rhythm, the right and left atria quiver. This can allow blood to pool in the atria instead of flowing smoothly through the heart and into the body.
When blood pools in the atria, it can form small clots. If one breaks away from inside the heart and gets into circulation, it could lodge in the brain, causing a stroke.
To reduce the risk of stroke, people with atrial fibrillation are often advised to take a blood thinner like warfarin or one of the newer alternatives, dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis). But blood thinners can cause severe and sometimes life-threatening bleeding.
Researchers from Johns Hopkins University School of Medicine wanted to see if imaging could identify people with atrial fibrillation who were at high stroke risk. They performed standard MRI scans of the hearts of 149 men and women with atrial fibrillation, then used special motion-tracking software to evaluate the images. The scans revealed specific changes in the muscles of the left atrium that increased stroke risk in some of the volunteers. These changes were not associated with age or other risk factors for stroke. The results were published online April 27th in the Journal of the American Heart Association.
Calculating stroke risk from atrial fibrillation
It would be great to have a way to identify which individuals with atrial fibrillation are at high risk of stroke and which ones are at low risk. The Hopkins study offers a step in that direction. But it is much too early to include MRI as part of the standard evaluation of people with atrial fibrillation — not to mention that such scans would significantly increase the cost of these evaluations. For now, doctors will continue to use standard tools to help determine stroke risk.
If you have atrial fibrillation, your stroke risk is high if you:
- are age 65 or older, and even higher if you are 75 or older
- have had a stroke or a mini-stroke (transient ischemic attack, or TIA) in the past
- have heart failure
- have blood vessels in any part of the body narrowed by cholesterol-filed plaque (vascular disease)
- have diabetes
- are a woman.
Experts have devised a tool called the CHA2DS2-VASc Score to calculate stroke risk for people with atrial fibrillation. It estimates this risk by taking into account age and sex; the presence or absence of heart failure, high blood pressure, narrowed blood vessels, and diabetes; and whether you’ve had a previous stroke, TIA, or blood clot. A low score indicates that warfarin or other clot-preventing medicine may not be needed.
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
Suppose you find fifty righteous people living there in the city—will you still sweep it away and not spare it for their sakes? (Genesis 18:24) And the Lord replied, “If I find fifty righteous people in Sodom, I will spare the entire city for their sake.” (Genesis 18:26)
And be sure to say, ‘Look, your servant Jacob is right behind us.’” Jacob thought, “I will try to appease him by sending gifts ahead of me. When I see him in person, perhaps he will be friendly to me.” (Genesis 32:20)
to say to you: ‘Please forgive your brothers for the great wrong they did to you—for their sin in treating you so cruelly.’ So we, the servants of the God of your father, beg you to forgive our sin.” When Joseph received the message, he broke down and wept. (Genesis 50:17)
“Forgive my sin, just this once, and plead with the Lord your God to take away this death from me.” (Exodus 10:17)
Pay close attention to him, and obey his instructions. Do not rebel against him, for he is my representative, and he will not forgive your rebellion. (Exodus 23:21)
Moses Intercedes for Israel The next day Moses said to the people, “You have committed a terrible sin, but I will go back up to the Lord on the mountain. Perhaps I will be able to obtain forgiveness for your sin.” (Exodus 32:30) So Moses returned to the Lord and said, “Oh, what a terrible sin these people have committed. They have made gods of gold for themselves. (Exodus 32:31) But now, if you will only forgive their sin—but if not, erase my name from the record you have written!” (Exodus 32:32)
The Lord passed in front of Moses, calling out, “Yahweh! The Lord! The God of compassion and mercy! I am slow to anger and filled with unfailing love and faithfulness. (Exodus 34:6) I lavish unfailing love to a thousand generations. I forgive iniquity, rebellion, and sin. But I do not excuse the guilty. I lay the sins of the parents upon their children and grandchildren; the entire family is affected— even children in the third and fourth generations.” (Exodus 34:7)
And he said, “O Lord, if it is true that I have found favor with you, then please travel with us. Yes, this is a stubborn and rebellious people, but please forgive our iniquity and our sins. Claim us as your own special possession.” (Exodus 34:9)
just as he does with the bull offered as a sin offering for the high priest. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:20) Then he must burn all the goat’s fat on the altar, just as he does with the peace offering. Through this process, the priest will purify the leader from his sin, making him right with the Lord, and he will be forgiven. (Leviticus 4:26)
Then he must remove all the goat’s fat, just as he does with the fat of the peace offering. He will burn the fat on the altar, and it will be a pleasing aroma to the Lord. Through this process, the priest will purify the people, making them right with the Lord, and they will be forgiven. (Leviticus 4:31) Then he must remove all the sheep’s fat, just as he does with the fat of a sheep presented as a peace offering. He will burn the fat on the altar on top of the special gifts presented to the Lord. Through this process, the priest will purify the people from their sin, making them right with the Lord, and they will be forgiven. (Leviticus 4:35)
The priest will then prepare the second bird as a burnt offering, following all the procedures that have been prescribed. Through this process the priest will purify you from your sin, making you right with the Lord, and you will be forgiven. (Leviticus 5:10) Through this process, the priest will purify those who are guilty of any of these sins, making them right with the Lord, and they will be forgiven. The rest of the flour will belong to the priest, just as with the grain offering.” (Leviticus 5:13)
Recommended contacts for prayer requests and Bible study
https://www.hopechannel.com/au/learn/courses
https://3abn.org/all-streams/3abn.html
http://www.nadadventist.org/article/15/contact-us
https://www.adventist.org/en/utility/contact/
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