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Clinical Performance Measures for Adults with AF

J Am Coll Cardiol; ePub 2016 Jun 27; Heidenreich, et al

Publish date:

The American College of Cardiology (ACC) and the American Heart Association (AHA) revised the existing clinical performance and quality measures for adults with atrial fibrillation (AF) or atrial flutter and these measure sets are intended to provide practitioners and institutions that deliver cardiovascular services with tools to measure the quality of care provided while identifying opportunities for improvement. Both revised and new AF measures were addressed in the guideline, as well as identifying future areas for measure development. Among the 21 new AF measures:

• CHA2DS2-VASc risk score documented prior to discharge.

• Anticoagulation prescribed prior to discharge.

• PT/INR planned follow-up documented prior to discharge for warfarin treatment.

• Beta blocker prescribed prior to discharge (when LVEF ≤40).

• Beta blocker prescribed (when LVEF ≤40).

• ACEI or ARB prescribed prior to discharge (when LVEF ≤40).

• Inappropriate prescription of antiarrhythmic drugs to patients with permanent AF prior to discharge for rhythm control.

• Inappropriate prescription of dofetilide or sotalol prior to discharge in patients with AF and end-stage kidney disease or on dialysis.

• Inappropriate prescription of antiplatelet and oral anticoagulation therapy prior to discharge for patients who do not have coronary artery disease and/or vascular disease.

• Shared decision making between physician and patient in anticoagulation prescription (prior to discharge).

Citation: Heidenreich PA, Solis P, Estes III M, et al. 2016 ACC/AHA clinical performance and quality measures for adults with atrial fibrillation or atrial flutter. [Published online ahead of print June 27, 2016]. J Am Coll Cardiol. doi:10.1016/j.jacc.2016.03.521.

Commentary: Atrial fibrillation is the most common cardiac arrhythmia in the US and is associated with both increased mortality and a 4- to 5-fold increase in the risk for stroke. From 1993 to 2000, the prevalence of atrial fibrillation has increased by 5% per year.1 This set of clinical performance measures provide measures by which to gauge quality of care for both inpatients and outpatients with Afib. —Neil Skolnik, MD

1. Piccini JP, Hammill BG, Sinner MF, et al. Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007. Circ Cardiovasc Qual and Outcomes. 2012;5:85–93. doi:10.1161/CIRCOUTCOMES.111.962688.

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