Top Things to Know: 2020 Update to the 2016 Clinical Performance and Quality Measures for Adults With Atrial Fibrillation or Atrial Flutter

Published: December 07, 2020

  1. This manuscript describes updates to the atrial fibrillation performance measures that are appropriate for public reporting or pay-for-performance programs.
  2. The performance measures are taken from the 2019 American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation guideline update and are selected from the strongest recommendations.
  3. The ACC/AHA Task Force on Performance Measures distinguishes quality measures from performance measures. Quality measures are those metrics that may be useful for local quality improvement but are not yet appropriate for public reporting or pay for performance programs.
  4. This document provides two performance measure changes prompted by changes to the 2019 AHA/ACC/HRS atrial fibrillation guideline update.
  5. The update clarifies that valvular atrial fibrillation is atrial fibrillation with either moderate or severe mitral stenosis or a mechanical heart valve. This clarification impacts all the performance measures.
  6. The CHA2DS2-VASc score for atrial fibrillation has a broader range (0 to 9) and includes a larger number of risk factors (female sex, 65-74 years of age, and vascular disease).
  7. The update specifies a more precise application of the CHA2DS2-VASc score by separating the treatment thresholds for males and females.


Heidenreich PA, Estes NAM 3rd, Fonarow GC, Jurgens CY, Kittleson MM, Marine JE, McManus DD, McNamara RL. 2020 Update to the 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures [published online ahead of print December 7, 2020]. Circ Cardiovasc Qual Outcomes. doi: 10.1161/HCQ.0000000000000100