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The Link Between Gum Health and Heart Rhythm: Treating Periodontitis May Improve Atrial Fibrillation Outcomes

Written by Andrew Le, MD

UpdatedApril 19, 2024

Atrial fibrillation (AF), the most common heart rhythm disorder, heightens the risk of stroke, heart failure, and mortality, shortening life expectancy. While treatment typically involves radiofrequency catheter ablation (RFCA), risk factor modification is critical for maintaining a stable heart rhythm post-ablation. A new study, conducted at Hiroshima University and published in the Journal of the American Heart Association, suggests that periodontitis, a gum infection, may be an underappreciated risk factor for AF.

The research team found that treating periodontitis within the 'blanking period' (the initial period following RFCA) significantly enhances the success rate of the ablation procedure. This prospective, non-randomized study involved 288 patients slated for first-time RFCA, each undergoing a periodontal inflamed surface area (PISA) assessment to quantify gum inflammation. Of these, 97 consented to periodontal treatment within the blanking period.

Throughout a follow-up period averaging 507 days, 70 patients experienced AF recurrences. Intriguingly, those with recurrences had higher PISA scores, with a high PISA being a statistically significant predictor of AF recurrence. Intervention in the form of periodontal treatment showed significantly fewer AF recurrences, cutting the risk by about 60%.

The implications are profound, indicating periodontitis may indeed be a modifiable AF risk factor. The study's findings urge the medical community to recognize the importance of dental health in managing heart rhythm disorders. With periodontal inflamed surface area serving as a potential marker of AF recurrence, dental examinations may benefit AF ablation candidates and treatment during the blanking period is highly recommended for those with severe periodontitis.

For more details on the study, visit the journal's webpage at www.ahajournals.org/journal/jaha.

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References

Miyauchi, S., Ouhara, K., Shintani, T., Tokuyama, T., Okubo, Y., Okamura, S., Miyamoto, S., Oguri, N., Uotani, Y., Takemura, T., Tari, M., Hiyama, T., Miyauchi, M., Kajiya, M., Mizuno, N., & Nakano, Y. (2024). Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation. Journal of the American Heart Association, 13, e033740. https://doi.org/10.1161/JAHA.123.033740