Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation
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 unde...
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Wiley
2024-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033740 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Shunsuke Miyauchi |
| collection | DOAJ |
| description | 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 mm2, P=0.001). These patients were categorized into high‐PISA (>615 mm2) and low‐PISA (<615 mm2) 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]; P=0.009). In patients with a high PISA, those who underwent periodontal treatment showed significantly fewer AF recurrences (P=0.01, log‐rank test). The adjusted HR of periodontal treatment for AF recurrence was 0.393 (95% CI, 0.215–0.719; P=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. |
| format | Article |
| id | doaj-art-dbefd95a1a784576a077fd080c7969a1 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-dbefd95a1a784576a077fd080c7969a12025-08-20T02:26:37ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113810.1161/JAHA.123.033740Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation AblationShunsuke Miyauchi0Kazuhisa Ouhara1Tomoaki Shintani2Takehito Tokuyama3Yousaku Okubo4Sho Okamura5Shogo Miyamoto6Naoto Oguri7Yukimi Uotani8Tasuku Takemura9Misako Tari10Toru Hiyama11Mutsumi Miyauchi12Mikihito Kajiya13Noriyoshi Mizuno14Yukiko Nakano15Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanCenter for Oral Clinical Examination Hiroshima University Hospital Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDivision of Medicine, Health Service Center Hiroshima University Higashihiroshima JapanDepartment of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanCenter for Oral Clinical Examination Hiroshima University Hospital Hiroshima JapanDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima JapanBackground 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 mm2, P=0.001). These patients were categorized into high‐PISA (>615 mm2) and low‐PISA (<615 mm2) 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]; P=0.009). In patients with a high PISA, those who underwent periodontal treatment showed significantly fewer AF recurrences (P=0.01, log‐rank test). The adjusted HR of periodontal treatment for AF recurrence was 0.393 (95% CI, 0.215–0.719; P=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.https://www.ahajournals.org/doi/10.1161/JAHA.123.033740modifiable risk factorperiodontal inflamed surface areaperiodontitisradiofrequency catheter ablationrecurrence |
| spellingShingle | 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 Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease modifiable risk factor periodontal inflamed surface area periodontitis radiofrequency catheter ablation recurrence |
| title | Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation |
| title_full | Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation |
| title_fullStr | Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation |
| title_full_unstemmed | Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation |
| title_short | Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation |
| title_sort | periodontal treatment during the blanking period improves the outcome of atrial fibrillation ablation |
| topic | modifiable risk factor periodontal inflamed surface area periodontitis radiofrequency catheter ablation recurrence |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033740 |
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