Periodontal disease reduces atrial fibrillation recurrence

Dental Tribune International

Fri. 26. April 2024

save

HIGASHIHIROSHIMA, Japan: Although periodontitis is not currently considered a modifiable risk factor for atrial fibrillation (AF), a recent study has examined whether periodontal treatment could improve the outcomes of catheter ablation, a minimally invasive procedure to correct AF. It found that treating periodontal disease a few months after the procedure may lower oral inflammation and reduce the recurrence of this irregular and often rapid heart rhythm in patients. The study is among the first to investigate the potential impact of periodontal disease treatment on AF.

AF affects the heart and results in an irregular heartbeat, thus increasing the risk of stroke, heart failure and even death. According to data from the American Heart Association, more than 12 million people in the US will have AF by 2030. Even more prevalent than AF is periodontal disease. According to the US Centers for Disease Control and Prevention, approximately half of American adults aged 30 or older have some form of periodontal disease, and the incidence increases with age. Therefore, the researchers sought to examine whether improving patients’ oral status could improve the outcome of catheter ablation.

The study was conducted from 1 April 2020 to 31 July 2022 and included 288 adults with AF who were scheduled to undergo catheter ablation, which uses radio frequency energy to destroy the heart tissue causing AF. All participants were examined by a dentist before undergoing catheter ablation for AF, and 97 patients also received treatment for periodontal inflammation.

The researchers followed up on the patients for 8.5 months to two years after the ablation procedure and found that AF recurred among 24% of the participants throughout the period. Additionally, they found that patients with severe periodontal inflammation who had received periodontal treatment after catheter ablation were 61% less likely to have a recurrence of AF compared with patients who did not receive periodontal treatment.

“Proper management of periodontal disease appears to improve the prognosis of AF, and many people around the world could benefit from it,” lead author Dr Shunsuke Miyauchi, an assistant professor in the Department of Cardiovascular Medicine at the Health Service Center at Hiroshima University in Japan, said in a press release.

The study also reported that those who had a relapse of AF were found to have more severe periodontal disease than those who did not have recurrences.

“While the main findings were consistent with their expectations, we were surprised how useful a quantitative index of gum disease, known as periodontal inflamed surface area or PISA, could be in cardiovascular clinical practice,” Dr Miyauchi noted. The study found that a high PISA, the sum of all bleeding areas in the periodontal pocket epithelia, predicted AF recurrence after catheter ablation.

“We are now working on further research to reveal the mechanism underlying the relationship between gum disease and AF,” he added.

The study, titled “Periodontal treatment during the blanking period improves the outcome of atrial fibrillation ablation”, was published online on 16 April 2024 in the Journal of the American Heart Association.