Top Things to Know: 2016 Clinical Performance and Quality Measures for Prevention of Sudden Cardiac Death
Published: December 19, 2016
- Over 350,000 cases of OHCA occur in the US each year, with a significant proportion resulting in death.
- Implementation of guideline-directed, evidence based recommendations for primary or secondary prevention of SCD may prevent a large number of deaths that occur from OHCA.
- This document provides strategies for effective implementation of guideline-based recommendations to improve quality of care for individual patients and have a measurable effect on the risk of SCD at the population level.
- In the area of preventive cardiology, performance measures to assess quality of care needed for patients at risk for SCD include smoking cessation in patients who have had SCA, have ventricular arrhythmias or are at risk for SCD.
- In resuscitation and emergency cardiovascular care, quality measures include referring family members of SCA patients for training in cardiopulmonary resuscitation (CPR) and automatic external defibrillator (AED) use.
- Performance measures in heart failure and general cardiology center on prevention of SCD in patients with heart failure or myocardial infarction (MI) along with reduced ejection fraction, using internal cardiac defibrillators (ICDs), and guideline-directed medical therapy.
- Electrophysiology performance measures include counseling eligible patients about ICD placement following assessment to rule out reversible causes of ventricular arrhythmias.
- Areas of interest relevant to future performance measures were identified for further study. Genetics is one area where there are strong links between SCD and certain disorders, but evidence to support a Class I recommendation is lacking. SCD in athletes is a high-profile event, yet there are many challenges to screening athletes for SCA.
- Several areas for future SCD development were identified for additional research, including adoption and evaluation of the measures, shared decision-making and accountability, and development of clinical data sources.
- This new performance measure set is expected to assist clinicians in providing better care to patients at risk of SCA, ultimately improving quality of patient care and outcomes. Much work remains to be done to continue imp
Citation
Al-Khatib SM, Yancy CW, Solis P, Becker L, Benjamin EJ, Carrillo RG, Ezekowitz JA, Fonarow GC, Kantharia BK, Kleinman M, Nichol G, Varosy PD. 2016 AHA/ACC clinical performance and quality measures for prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures [published online ahead of print December 19, 2016]. Circ Cardiovasc Qual Outcomes. doi: 10.1161/HCQ.0000000000000022.