The 2026 AHA/ACC writing committee developed a comprehensive AF performance and quality measure set — 5 performance measures (suitable for public reporting/pay-for-performance) and 16 quality measures (for local quality improvement) — derived from Class 1 or 3 recommendations in the 2023 ACC/AHA/ACCP/HRS AF Guideline, covering newly diagnosed AF evaluation, anticoagulation, rhythm/rate control, catheter ablation, and health equity.
The final set includes 21 measures: 5 performance measures (PM-1 through PM-5) targeting basic clinical evaluation, secondary prevention, stroke risk documentation, DOAC prescribing, and post-PCI antithrombotic therapy; and 16 quality measures (QM-1 through QM-16) covering equity, LAA exclusion during surgery, antithrombotic safety, shared decision-making, antiarrhythmic drug safety, catheter ablation use, and HFrEF-specific rhythm control.
- This is a guideline-derived consensus document, not an empirical study; no patient-level outcomes data are reported. - Many quality measures are not yet ready for public reporting due to feasibility gaps, evolving evidence, or difficulty measuring adherence with existing data systems. - Equity measure (QM-1) acknowledges that multiple dimensions of disparity make uniform implementation difficult.
Clinicians should document a validated stroke risk score at least annually, prescribe DOACs when indicated (preferring DOACs over warfarin for non-valvular AF), offer shared decision-making on rhythm vs. rate control, and refer eligible patients with HFrEF and AF for catheter ablation — gaps that this measure set directly targets. Health systems should track AF care delivery by race/ethnicity, sex, and social determinants of health to identify and close persistent equity gaps in anticoagulation, rhythm control, and ablation referral.
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