# Multimorbidity, Rurality, and Outcomes in Atrial Fibrillation in the Community

> **NIH NIH R21** · MAYO CLINIC ROCHESTER · 2020 · $202,031

## Abstract

PROJECT SUMMARY
Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting up to 6 million Americans. The
incidence of AF has stabilized over the last decade, and despite continued emphasis on optimizing treatment
strategies for AF, their outcomes have largely not improved. These concerning findings indicate that the
epidemic of AF persists and its burden is unabated in recent years.
 We hypothesize that the failure to control the AF epidemic is related to an inadequate understanding of
co-existing conditions and the lack of knowledge on the impact of rurality and neighborhood characteristics on
outcomes in AF. Indeed, most hospitalizations and deaths in AF patients are attributed to non-cardiovascular
causes, suggesting that comorbid conditions play a significant role in outcomes. Functional status may also
fundamentally impact outcomes and healthcare utilization in elderly patients with AF, and as such was
highlighted as a key research opportunity in AF, yet is seldom available in AF cohorts. Finally, the
communities in which people live affect the healthcare they receive and their overall health, and notably, rural
populations experience a disproportionate burden of deaths due to heart disease. Thus, the central goal of
our application is to define the impact of comorbidities, activities of daily living, rurality, and characteristics of
the area in which the patient lives, on non-fatal and fatal outcomes (recurrence of AF, progression to
permanent AF, ischemic stroke and transient ischemic attack, heart failure, dementia, healthcare utilization
including hospitalizations, emergency department visits, and outpatient visits, and all-cause and cardiovascular
death) in AF. We will respond to the urgent need to study the comorbidity burden in these elderly patients, a
step that is essential to inform practice guidelines with clinically applicable performance measures, and will
offer a unique opportunity to study the impact of rurality and neighborhood characteristics on outcomes in AF,
which is not feasible using data from clinical trials, registries, claims, or the electronic medical record alone.
 The impact of these studies will be high as they will fill an important gap in our understanding of AF by
providing data on the most critical factors associated with outcomes. The proposed research makes an
efficient use of rich data available through the Rochester Epidemiology Project (R01 AG034676), a unique
research infrastructure which captures the complete health care experience of patients living in a
geographically defined population. The knowledge gained will provide new information of critical clinical
relevance vital to design more effective interventions to manage AF and improve its outcomes.

## Key facts

- **NIH application ID:** 10003913
- **Project number:** 5R21AG062580-02
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Alanna M Chamberlain
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $202,031
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10003913

## Citation

> US National Institutes of Health, RePORTER application 10003913, Multimorbidity, Rurality, and Outcomes in Atrial Fibrillation in the Community (5R21AG062580-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10003913. Licensed CC0.

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