Top Things to Know: 2026 Clinical Performance and Quality Measures for Patients With Atrial Fibrillation
Updated: August 17, 2026
- The current document includes a comprehensive list of measures (5 performance and 16 quality) that are based on Class 1 or 3 recommendations from the “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation.”
- The 5 performance measures meet preferred attributes such as being high value, targeting meaningful gaps in care, and being actionable, and are unlikely to have substantive unintended consequences.
- The 5 performance measures listed are appropriate for public reporting or pay-for-performance programs.
- The performance measures emphasize providing an appropriate basic evaluation for new-onset atrial fibrillation (AF); providing comprehensive secondary prevention to prevent progression and complications of AF at all stages, including weight loss, physical activity, smoking cessation, alcohol moderation, and optimal blood pressure control, if indicated; documenting a validated stroke and systemic embolism risk score annually; and prescribing direct oral anticoagulants if indicated.
- Quality measures in general are not yet ready for public reporting or pay-for-performance programs, but they might be useful to clinicians and health care organizations for purposes of quality improvement.
- To optimize health equity and outcomes across all patient populations, a quality measure was added to encourage health systems to measure the receipt of guideline-directed oral anticoagulation; rhythm- or rate-control strategies; and lifestyle and risk-factor management across important demographic groups, such as by sex or gender, race and ethnicity, or social determinants of health.
- For all measures, exclusions from the measure are identified, including if the clinician determines that the care is inappropriate for the patient; if the patient is unlikely to benefit from the measure (eg, a patient receiving hospice or comfort care); or if the patient declines treatment or care.
- A patient-centered discussion of the benefits and risks of rhythm- versus rate-control strategies in AF was added as a quality measure.
- A quality measure was added to reflect the increasing importance of rhythm control in patients with heart failure with reduced ejection fraction and AF.
- 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.
Citation
Benjamin EJ, Marcus GM, Hess PL, Addison D, Akar J, Brownell NK, Chyou JY, Derington CG, Diekemper RL, Frankel DS, Hu GS, Ibeh C, Jackson LR II, Joynt Maddox KE, Turchoie MR, Tisdale JE, Yang E. 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. Circ Popul Health Outcomes. Published online August 17, 2026. doi: 10.1161/HCQ.0000000000000149