Treating Gum Disease May Reduce Risk of Irregular Heartbeat Recurrence

A new study suggests that treating gum disease within three months after a procedure to correct an irregular heartbeat, known as atrial fibrillation (AFib), may lower oral inflammation and reduce the chances of AFib coming back. The findings were published in the Journal of the American Heart Association.

Gum disease, or periodontal disease, is a common problem in the United States, affecting about half of adults aged 30 or older, according to the Centers for Disease Control and Prevention (CDC). The risk of gum disease increases with age.

AFib is a condition in which the heart beats irregularly, increasing the risk of stroke by five times. By 2030, more than 12 million people in the U.S. are expected to have AFib, according to the American Heart Association.

“Gum disease can be modified by 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 lead study author Shunsuke Miyauchi, M.D., Ph.D., an assistant professor at the Health Service Center at Hiroshima University in Japan.

The study followed 97 patients who had undergone a non-surgical procedure called radiofrequency catheter ablation to correct AFib and received treatment for gum inflammation. They were compared to 191 ablation patients who did not receive treatment for gum disease. Catheter ablation uses radiofrequency energy to destroy a small area of heart tissue causing rapid and irregular heartbeats.

During the average follow-up period of 8.5 months to 2 years after the ablation procedure, the researchers found that AFib recurred in 24% of all participants. However, patients with severe gum inflammation who had it treated after the ablation were 61% less likely to have a recurrence of AFib compared to those who did not receive treatment for severe gum inflammation. Patients who had recurrences of AFib also had more severe gum disease than those who did not have recurrences.

The study identified several predictors for AFib recurrences, including having gum disease, being female, experiencing irregular heartbeat for more than two years, and having a larger left atrial volume, which often leads to AFib recurrence due to thickening and scarring of connective tissues.

Miyauchi noted that while the main findings were consistent with their expectations, they were surprised by how useful a quantitative index of gum disease, known as periodontal inflamed surface area or PISA, could be in cardiovascular clinical practice.

Although the American Heart Association does not recognize oral health as a risk factor for heart disease, it acknowledges that oral health can be an indicator of overall health and well-being. Bacteria from inflamed teeth and gums may travel through the bloodstream to other parts of the body, including the heart and brain. Chronic gum inflammation may also be associated with other systemic health conditions, such as coronary artery disease, stroke, and Type 2 diabetes.

The study had some limitations, including a small number of patients from a single center, non-randomized treatment, and lack of follow-up on periodontal status and inflammatory markers after the ablation procedure.

Despite these limitations, the findings suggest that treating gum disease may have a positive impact on the success of AFib treatment and reduce the risk of recurrence. Further research is needed to better understand the underlying mechanisms linking gum disease and AFib.