Treating gum disease after heart rhythm ablation reduced risk of AFib recurrence

Research highlights:

  • Treating gum disease within three months of heart surgery to correct an irregular heart rhythm called atrial fibrillation (AFib) may reduce the chance of its recurrence.
  • Inflamed gums may signal the return of atrial fibrillation after cardiac ablation, a procedure to repair an irregular heartbeat.
  • Researchers say people with atrial fibrillation should be screened for gum disease and encouraged to seek dental treatment.

Embargoed until Wednesday, April 10, 2024 at 4am Central Time / 5am Eastern Time

DALLAS, April 10, 2024 – Treating gum disease within 3 months of surgery to correct atrial fibrillation (AFib) arrhythmia (AFib) may help, according to a new study published today in The Verge. Reduces oral inflammation and may reduce AFib recurrence. Journal of the American Heart Associationthe American Heart Association's open-access, peer-reviewed journal.

About half of U.S. adults age 30 or older have some form of periodontal or gum disease, and the incidence increases with age, according to the Centers for Disease Control and Prevention (CDC).

This study is one of the first to investigate the potential impact of gum disease treatment on AFib. AFib is a disease in which the heart beats irregularly, increasing the risk of stroke fivefold. According to the American Heart Association's 2024 Heart Disease and Stroke Statistics, more than 12 million people in the United States are expected to have AFib by 2030.

“Gum disease can be improved through dental intervention. Proper management of gum disease appears to improve the prognosis of AFib, and many people around the world could benefit from it,” said the study's lead author, Dr. Shunsuke Miyauchi, assistant professor at Hiroshima University Health Services Center . Engaged in general cardiology, arrhythmia practice and research in Japan.

Researchers followed 97 patients who underwent non-surgical treatment for AFib (radiofrequency catheter ablation) and were treated for gum inflammation, as well as 191 ablation patients who did not receive treatment for gum disease. Catheter ablation is a procedure that uses radiofrequency energy to destroy a small area of ​​heart tissue, causing a fast and irregular heartbeat. This study found that an index measuring the severity of gum inflammation was associated with the recurrence of AFib.

After the ablation procedure, over an average follow-up period of 8.5 months to 2 years, the researchers found:

  • Over the entire follow-up period, 24% of participants developed AFib again.
  • Patients with severe gingival inflammation who were treated after cardiac catheter ablation were 61% less likely to have AFib recurrence compared with ablation patients who did not receive treatment for severe gingival inflammation.
  • Patients whose AFib relapses have more severe gum disease than those who do not.
  • Having gum disease, being female, experiencing arrhythmias for more than two years, and left atrial volume were predictors of AFib recurrence. Miyauchi explained that left atrial volume often contributes to AFib recurrence because it includes connective tissue thickening and scarring.

Miyauchi noted, “While the main findings were consistent with their expectations, we were surprised by how useful a quantitative index of gum disease, called periodontal inflamed surface area, or PISA, would be in cardiovascular clinical practice.

While the American Heart Association does not consider oral health a risk factor for heart disease, it recognizes that oral health can serve as an indicator of overall health and well-being. Bacteria in inflamed teeth and gums may spread through the bloodstream to other parts of the body, including the heart and brain. Chronic gum inflammation may be associated with other systemic health conditions, including coronary artery disease, stroke, and type 2 diabetes.

Study details and background:

  • A total of 288 adults (66% men; 34% women) receiving AFib participated in the study.
  • This single-center study was conducted at Hiroshima University Hospital in Hiroshima, Japan, from April 1, 2020, to July 31, 2022, and all participants were Asian.
  • Participants were examined by a dentist before undergoing catheter ablation of AFib.

We are now conducting further studies to uncover the underlying mechanisms of the relationship between gum disease and AFib,” Miyauchi said.

Study limitations include: a small number of patients recruited from a single center; patients were not randomly assigned to receive dental treatment; participants who did not receive treatment for gum disease were not followed for periodontal status after the initial examination; and patients were not re-examined after ablation procedures Assess markers of inflammation.

Co-authors, disclosures, and funding sources are listed in the manuscript.

Research published in American Heart Association scientific journals is peer-reviewed. The statements and conclusions in each manuscript represent the views and conclusions solely of the study authors and do not necessarily reflect the policy or position of the Society. The Association makes no representations or warranties as to its accuracy or reliability. The Association's funding comes primarily from individuals; foundations and corporations (including pharmaceutical companies, device manufacturers, and other companies) also contribute and fund specific Association programs and activities. The association has strict policies to prevent these relationships from influencing scientific content. Revenues for pharmaceutical and biotechnology companies, device manufacturers and health insurance providers, as well as overall financial information for the association, are available here.

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