Department of Research & Evaluation News

Atrial fibrillation — a problem with the rate or rhythm of the heartbeat — is the most common type of arrhythmia in adults. It occurs when rapid, disorganized electrical signals cause the atria, the two upper chambers of the heart, to contract very fast or irregularly. This causes blood to pool in the atria and not be pumped completely into the ventricles, the hearts two lower chambers. As a result, the hearts upper and lower chambers dont work together as efficiently as they should, according to the researchers.

They explain that often people who have atrial fibrillation may not feel symptoms. However, atrial fibrillation is one of the most potent risk factors for ischemic stroke, the leading cause of disability and third leading cause of death in the U.S. More than 2.2 million Americans currently have recognized atrial fibrillation and this number is expected to increase at least 2.5-fold over the next 50 years, with more than 50 percent of affected individuals aged 80 years or older, according to the researchers.

The Kaiser Permanente Atrial Fibrillation Cohort for Healthcare Evaluation and Risk Assessment (or ARCHER) study, funded by the National Heart, Lung and Blood Institute of the National Institutes of Health, will look at a prospective cohort of members in Kaiser Permanente Northern and Southern California who were diagnosed with atrial fibrillation between 2006-2009 to examine the contemporary evaluation, management and outcomes of adults with atrial fibrillation. The ARCHER Study will combine information from a patient survey and detailed information from Kaiser Permanente electronic medical records.

While greater adherence to proven therapies and development of newer treatments to prevent atrial fibrillation-related complications will benefit those currently diagnosed with the condition, the ARCHER study will help us identify more accurately which atrial fibrillation patients are at high risk for stroke and bleeding. It will also help us better personalize treatment for those who need it, said the studys co-lead investigator, Alan S. Go, Director of the Kaiser Permanente Comprehensive Clinical Research Unit.

Given the expected increase in the prevalence of atrial fibrillation, there is an urgent need to know which patients will benefit most from various treatment strategies in order to reduce the substantial societal burden associated with atrial fibrillation, said Kristi Reynolds, PhD, MPH, a scientist with the Department of Research and Evaluation.

A unique strength of the ARCHER Study is the collaboration between the researchers of Kaiser Permanente Southern and Northern California to conduct the largest survey and follow-up study to date of adults diagnosed with atrial fibrillation in the current treatment era. This study is also leveraging a common electronic medical record system (KP HealthConnect) and other clinical and administrative databases to efficiently conduct this large-scale cohort study.

Researchers are contacting approximately 27,000 adult Kaiser Permanente members in California who have been diagnosed with atrial fibrillation. In their initial survey, researchers will gather data about family medical history, certain health behaviors, and selected medications patients may be taking.

Once survey data is gathered, Kaiser Permanente researchers will combine this information with other information from the electronic medical records to evaluate the types of testing, treatment and clinical outcomes they experience.

The research is voluntary and answers are confidential. Reports using this research information will always describe whole groups of members, never individuals. Answers to survey questions never become part of the medical record, and will never be given to health care providers or health plan administrators.