Treating Gum Disease Could Reduce Recurrence of Atrial Fibrillation

Japanese Study Examines Impact of Periodontal Treatment During “Blanking Period” After Ablation

JAPAN: In a recent study published in the Journal of the American Heart Association, researchers at Hiroshima University Hospital explored the relationship between gum disease and the recurrence of atrial fibrillation (AF) following radiofrequency catheter ablation (RFCA) treatment.

The researchers enrolled 330 patients with AF who were undergoing initial RFCA procedures between April 2020 and July 2022. Patients underwent a periodontal examination the day before their RFCA procedure, with the severity of their gum disease quantified using the periodontal inflamed surface area (PISA) metric.

“Those consenting underwent recommended nonsurgical periodontal treatment during the blanking period, especially at 1 and 3 months post-RFCA,” the researchers explained.

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Gum Disease Linked to Higher Recurrence Rates

The study found that patients with higher PISA scores, indicating more severe gum disease, were more likely to experience recurrences of AF within 12 months of their RFCA procedure. Receiver operating characteristic analysis revealed a PISA cutoff of 615.8 mm2, with those in the “high PISA” group showing “significantly lower AF recurrence-free survival rates.”

“Patients with higher PISA were more likely to experience recurrences,” the researchers noted.

Importantly, the researchers found that patients who received periodontal treatment during the “blanking period” – the first few months after RFCA when the risk of recurrence is highest – experienced fewer AF recurrences compared to those who did not receive treatment.

“Kaplan-Meier analyses demonstrated that the treatment group experienced fewer AF recurrences compared to the non-treatment group within 12 months, particularly those with high baseline PISA.”

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Implications for Atrial Fibrillation Management

The findings of this study suggest that integrating dental health into the comprehensive management of atrial fibrillation could be a valuable strategy. By identifying and treating gum disease, particularly in the critical period following RFCA, clinicians may be able to reduce the risk of AF recurrence and improve outcomes for patients.

“The research highlights a significant link between systemic inflammation induced by periodontitis and AF pathogenesis, advocating for integrating dental health into AF management,” the researchers concluded.