Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2024 Apr 10

PMID 38597139

Authors

Shunsuke Miyauchi

Kazuhisa Ouhara

Tomoaki Shintani

Takehito Tokuyama

Yousaku Okubo

Sho Okamura

Shogo Miyamoto

Naoto Oguri

Yukimi Uotani

Tasuku Takemura

Misako Tari

Toru Hiyama

Mutsumi Miyauchi

Mikihito Kajiya

Noriyoshi Mizuno

Yukiko Nakano

Affiliations

Soon will be listed here.

Abstract

Background: Periodontitis has not been recognized as a modifiable risk factor for atrial fibrillation (AF). This prospective nonrandomized study investigated whether periodontal treatment improves the AF ablation outcome.

Methods And Results: We prospectively enrolled 288 AF patients scheduled to undergo initial radiofrequency catheter ablation. Each patient underwent periodontal inflamed surface area (PISA; a quantitative index of periodontal inflammation) measurement. All eligible patients were recommended to receive periodontal treatment within the blanking period, and 97 consented. During the mean follow-up period of 507±256 days, 70 (24%) AF recurrences were documented. Patients who exhibited AF recurrences had a higher PISA than those who did not (456.8±403.5 versus 277.7±259.0 mm, =0.001). These patients were categorized into high-PISA (>615 mm) and low-PISA (<615 mm) groups according to the receiver operating characteristic analysis for AF recurrence (area under the curve, 0.611; sensitivity, 39%; specificity, 89%). A high PISA, as well as female sex, AF duration, and left atrial volume, were the statistically significant predicter for AF recurrence (hazard ratio [HR], 2.308 [95% CI, 1.234-4.315]; =0.009). In patients with a high PISA, those who underwent periodontal treatment showed significantly fewer AF recurrences (=0.01, log-rank test). The adjusted HR of periodontal treatment for AF recurrence was 0.393 (95% CI, 0.215-0.719; =0.002).

Conclusions: Periodontitis may serve as a modifiable risk factor for AF. PISA is a hallmark of AF recurrence, and periodontal treatment improves the AF ablation outcome, especially for those with poor periodontal condition.

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