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August 1, 2026Journal of the American College of Cardiology
2026 AHA/ACC Clinical Performance and Quality Measures for Patients With Atrial Fibrillation
Why the study?
AF is increasing in burden and risk of stroke, heart failure, and mortality, making equitable adherence to evidence-based recommendations critical to advancing clinical care, patient outcomes, and public health.
Key Points
- A clinical framework establishes 5 performance and 16 quality measures to improve care equity and patient outcomes across all stages of atrial fibrillation.
- Guideline recommendations from the 2023 ACC/AHA/ACCP/HRS Class 1 and 3 guidance informed metrics targeting clinical evaluation and stroke risk documentation.
- Implementation supports secondary prevention through appropriate anticoagulation and catheter ablation in patients with heart failure with reduced ejection fraction.
Structured PICO
P
Population
Patients with atrial fibrillation
I
Intervention
Implementation of 5 performance measures and 16 quality measures derived from the 2023 ACC/AHA/ACCP/HRS Guideline
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We put a line in the sand about the importance of secondary prevention to prevent atrial fibrillation progression and complications at all stages.”
“The document includes five performance measures that focus on ensuring that patients with newly diagnosed AFib receive a comprehensive initial evaluation, as well as promote secondary prevention strategies such as weight management, physical activity, smoking cessation, alcohol moderation and blood pressure control. They also include documenting validated stroke and systemic embolism risk assessments annually and prescribing appropriate anticoagulation when indicated.”
“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.'”
Implication
This document provides 5 performance and 16 quality measures to ensure evidence-based, equitable care for patients with atrial fibrillation.
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.
Coverage & sources
Journal, society, and media accounts. Useful signal, not independent expert judgment.
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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 writing committee developed 5 performance measures and 16 quality measures to advance the quality and equity of care for patients with atrial fibrillation.