Treating Afib: 4D Blood Flow MRI


MIAMI, Fla (Ivanhoe Newswire) — More than six million Americans suffer from atrial fibrillation, a condition that makes your heart race and can cause a stroke. Now a new study is aimed at finding those patients who are at risk, helping doctors make better decisions about treatments.

This is one of Richard Amundsen’s favorite hobbies.

“I do enjoy playing the piano,” Amundsen said.

But the music almost stopped when Amundsen’s heart beat started to race.

“Occasionally it would go up and all of a sudden I would be at 170 beats per minute,” Amundsen told Ivanhoe.

Jeffrey Goldberger, MD, Chief of the Cardiovascular Division at the University of Miami Miller School of Medicine says Amundsen’s condition, atrial fibrillation, affects the way blood flows through the heart, which can cause clots.

“If those travel anywhere to the body, particularly the brain, it can cause a stroke,” said Dr. Goldberger. (Read Full Interview)

Most patients like Amundsen are put on blood thinners to prevent stroke. But there are dangerous side effects.

Dr. Goldberger said, “The blood thinners have a three percent risk of major bleeding per year.”

Dr. Goldberger and his team at the University of Miami are studying a better way to predict which afib patients are at high risk of forming these clots. It’s called 4D flow MRI.

Dr. Goldberger said, “What it allows us to do is actually measure in every part of the atrium the blood flow velocity or speed throughout the cardiac cycle.”

The researchers are studying patients who undergo cardioversion therapy to shock their heart back into normal rhythm.

“We’re hoping to find that actually restoring the rhythm to normal improves the blood flow velocity.” Dr. Goldberger told Ivanhoe.

Allowing doctors to make better decisions about who needs to be on blood thinners and who does not.

“I’ve been very lucky,” Amundsen said.

Amundsen had cardioversion to eliminate his afib.

“I’m enjoying my life,” he told Ivanhoe.

Amundsen is one of a dozen participants in the 4D flow MRI study. Dr. Goldberger says they are just collecting data now and plan to start a large clinical trial by next year.


Contributors to this news report include: Janna Ross, Field Producer; Judy Reich, Videographer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.


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BACKGROUND: Atrial fibrillation (AFib) is the most common problem with your heartbeat’s rate or rhythm. The basic cause of AFib is disorganized signals that make the hearts two upper chambers squeeze very fast and out of sync. They contract so quickly that the heart walls quiver or fibrillate. Damage to your heart’s electrical system can cause AFib. This damage often results from other conditions that affect the heart. But in at least one of every 10 AFib cases, other things may be at play. Sometimes, doctors can’t figure out what’s causing AFib.



STROKE AND BLOOD CLOTS: When it comes to treating AFib there are two primary treatment goals: 1) Reducing the risk of blood clots and stroke and 2) Managing abnormal heart rate or rhythm. As a result, patients may need one or more medications to treat their AFib. Reducing stroke risk is an important part of treating AFib. To help reduce the risk of AFib-related stroke, healthcare providers may prescribe anticoagulants or antiplatelets, which are both blood thinners to help prevent blood clots from forming. There are different kinds of blood thinners. Older blood thinners require regular blood tests to monitor how the blood thinners are working. Newer blood thinners do not. Patients should check with their physician to see which kind of blood thinners are best for them.



NEW TECHNOLOGY: Jeffrey Goldberger, MD, Chief of the Cardiovascular Division at University of Miami Miller School of Medicine said, “we’re using a technique called 4D flow MRI which is just a specialized analysis of typical cardiac MRI information that we get. And what it allows us to do is actually measure in every part of the atrium, the blood flow velocity or speed throughout the cardiac cycle.” Dr. Goldberger’s goal is to find out which patients are at risk for stroke: “the annual risk of not having a stroke is 95 percent. And if you were to just annualize that for five years probably 60 percent will not have a stroke in five years. So now think about the fact that we’re treating the 60 percent that are not going to have a stroke in five years with blood thinners over those five years and the blood thinners have a three percent risk of major bleeding per year. That’s where we can begin to have some impact. If we can figure out who that 60 percent are and not put them on the blood thinners then we will have done an amazing thing.” For more information please visit

(Source: Jeffrey Goldberger, MD)



Kai Hill, PR University of Miami Miller School of Medicine


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Doctor Q and A

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