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August 17, 2026Circulation Population Health and Outcomes
2026 AHA/ACC Clinical Performance and Quality Measures for Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures
Why the study?
AF is rising in incidence, prevalence, and lifetime risk, worsening clinical risks and costs, making equitable adherence to evidence-based recommendations essential.
Key Points
- Standardized performance and quality measures establish clinical benchmarks in atrial fibrillation, aiming to reduce long-term stroke risk and patient mortality.
- The panel established 5 performance and 16 quality measures to guide anticoagulation therapy, prioritizing the strongest evidence-based recommendations.
- Guideline recommendations highlight catheter ablation for heart failure with reduced ejection fraction, advancing care quality and equity across populations.
Structured PICO
P
Population
Patients with Atrial Fibrillation (AF)
I
Intervention
Implementation of 5 performance measures and 16 quality measures derived from the 2023 ACC/AHA/ACCP/HRS Guideline
The AHA/ACC developed 21 performance and quality measures to improve adherence to evidence-based recommendations and advance equitable care for patients with atrial fibrillation.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The 16 quality measures cover a variety of topics including measuring and addressing health inequities, optimizing antiarrhythmic or anticoagulant treatment, engaging in shared decision-making for rate vs. rhythm-control strategies, and, in appropriate patients, offering catheter ablation for those with heart failure with reduced ejection fraction.”
“performance and quality measures are intended to translate scientific evidence into clinical practice and are designed to provide practitioners and health systems with tools to measure the quality of care provided and identify opportunities for improvement.”
Implication
These 5 measures enable standardized, equitable AF quality assessment; extends guidelines into actionable public reporting and pay-for-performance standards.
Abstract
Atrial fibrillation (AF) is increasing in incidence, prevalence, and lifetime risk, and contributes to substantially greater health care costs and increased risks of stroke, heart failure, and mortality. Improving adherence to evidence-based recommendations equitably in AF is critical to advancing clinical care, patient outcomes, and public health. The writing committee developed a comprehensive set of 5 performance measures, which are appropriate for public reporting or pay-for-performance programs, and 16 quality measures, which are useful to clinicians and health care organizations for quality improvement. The writing committee selected the measures from the strongest recommendations (Class 1 or 3) in the “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation.” The purpose of the writing committee’s performance measures is meant to ensure that patients with newly diagnosed AF receive a basic clinical evaluation, with an emphasis on secondary prevention for patients at all stages of AF, documenting stroke risk, and, if indicated, providing appropriate anticoagulation. AF quality measures cover a variety of topics including measuring and addressing health inequities, optimizing antiarrhythmic or anticoagulant treatment, engaging in shared decision-making for rate- versus rhythm-control strategies, and, in appropriate patients, offering catheter ablation for those with heart failure with reduced ejection fraction. The performance and quality measures are intended to advance the quality and equity of AF care across all patient populations with AF.
Discussion
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Cite This Study
Benjamin et al. (2026) conducted a review in Atrial fibrillation. Clinical Performance and Quality Measures was evaluated. The AHA/ACC joint committee developed 5 performance measures and 16 quality measures to improve adherence to evidence-based recommendations and advance the quality and equity of atrial fibrillation care.