Top Things to Know: 2026 AHA/ACC Clinical Performance and Quality Measures for Patients With Atrial Fibrillation
Published: January 08, 2026
- The current document includes a comprehensive list of measures (5 performance and 16 quality) that are based on Class 1 or Class 3 recommendations from the 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation.
- The 5 performance measures meet recommended attributes, such as being high impact, 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; providing comprehensive secondary prevention to prevent progression and complications of atrial fibrillation at all stages; and assessing stroke risk and providing appropriate anticoagulation if indicated.
- Quality measures are provided that are not yet ready for public reporting or pay for performance but might be useful to clinicians and health care organizations for 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 the care is inappropriate for the patient; if the patient is unlikely to benefit from the measure (e.g., 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 atrial fibrillation 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 atrial fibrillation.
- 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.