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In a multivariable-adjusted analysis with 0 fulfilled performance measures as reference, the HRs (95% CIs) were 1 0.78 (0.61-1.0, 2 0.63 (0.49-0.8, 3 0.53 (0.36-0.8, 4 0.64 (0.44-0.94), 5 0.56 (0.39-0.82), 6 0.51 (0.35-0.74), and 7 0.49 (0.33-0.73), with a significant decreasing linear trend (p 0.001). In patients with incident HF, fulfillment of guideline-based process performance measures was associated with decreased long-term risk of AF. This study supports initiatives to improve the quality of care for patients with HF