Home/Measures/Heart Rate Control in AFib
Measure ID: AVBC1|Cardiovascular|Approved: 2025CMS APPROVED

Heart Rate Control in Atrial Fibrillation

Evaluates effectiveness of pharmacological rate control in atrial fibrillation patients. Targets heart rate <110 bpm, aligning with ACC/AHA guidelines.

Measure Rationale

Effective rate control in atrial fibrillation reduces symptoms, prevents complications such as tachycardia-induced cardiomyopathy, and improves patient outcomes. Despite clear guideline recommendations, many patients with AFib do not achieve adequate rate control.

Measure Specification

Denominator

All patients aged 18 years and older with a diagnosis of atrial fibrillation on rate control pharmacotherapy.

Denominator Exclusion

Patients with contraindications to rate control therapy or those pursuing rhythm control strategy as primary management.

Numerator

Performance Met:

Resting heart rate documented at <110 bpm during the measurement period.

Performance Not Met:

Resting heart rate documented at ≥110 bpm or no heart rate documented during the measurement period.

Numerator Exclusion

None

Clinical Recommendation Statement

The ACC/AHA/HRS guidelines for the management of atrial fibrillation recommend a lenient rate control strategy with a target resting heart rate of <110 bpm for patients with permanent atrial fibrillation who remain symptomatic despite stricter rate control.

References

  • 1.

    January CT, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Circulation. 2019.

  • 2.

    Van Gelder IC, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362(15):1363-1373.

Use this measure in your practice

This measure is available through VBCA's CMS-approved QCDR. First and second-year measures receive automatic MIPS points regardless of performance.