Tashiro Akira, Yonetsu Taishi, Aoyama Norio, Shiheido-Watanabe Yuka, Niida Takayuki, Miyazaki Shinsuke, Maejima Yasuhiro, Goya Masahiko, Isobe Mitsuaki, Iwata Takanori, Sasano Tetsuo
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Periodontology, Kanagawa Dental University, Yokosuka, Japan.
Front Cardiovasc Med. 2023 Jan 9;9:1061243. doi: 10.3389/fcvm.2022.1061243. eCollection 2022.
Periodontitis (PD), a common chronic inflammatory disease, may be associated with the subsequent development of atrial fibrillation (AF) through a mechanism of systemic inflammation. However, little is known about the impact of PD on the recurrence of atrial fibrillation after catheter ablation (CA).
A total of 132 patients (age 62.2 ± 10.6 years; 72.7% male) who underwent periodontal examinations and the first CA for paroxysmal atrial fibrillation (PAF) were investigated. Clinical periodontal examination was performed by independent trained periodontists, and patients were diagnosed with PD when the maximum periodontal probing depth was equal to or greater than 4 mm and bleeding on probing was evident. Of these, 71 patients (54%) were categorized as those with PD (PD group) and the other 61 (46%) as those without PD (non-PD group). Pulmonary vein isolation was performed in a standard fashion.
Kaplan-Meier curve analysis revealed worse atrial arrhythmia recurrence-free survival probabilities after CA for PAF in the PD group than in the non-PD group (64.8% versus 80.3%, respectively; = 0.024) during a median follow-up period of 3.0 (interquartile range: 1.1-6.4) years. Cox regression analysis revealed PD as a significant predictor of arrhythmia recurrence (hazard ratio: 2.063, 95% confidence interval: 1.018-4.182), after adjusting for age and gender.
Periodontitis was independently associated with an increased risk of arrhythmia recurrence after the first CA for PAF. Our results may suggest that the periodontal status is potentially a modifiable determinant of the outcomes after PAF ablation, and further prospective studies are warranted.
牙周炎（PD）是一种常见的慢性炎症性疾病，可能通过全身炎症机制与随后发生的心房颤动（AF）相关。然而，关于PD对导管消融（CA）后心房颤动复发的影响知之甚少。
共调查了132例接受牙周检查并首次因阵发性心房颤动（PAF）进行CA的患者（年龄62.2±10.6岁；72.7%为男性）。由独立培训的牙周病医生进行临床牙周检查，当最大牙周探诊深度等于或大于4mm且探诊出血明显时，患者被诊断为患有PD。其中，71例患者（54%）被归类为患有PD的患者（PD组），另外61例（46%）为未患有PD的患者（非PD组）。以标准方式进行肺静脉隔离。
Kaplan-Meier曲线分析显示，在中位随访期3.0年（四分位间距：1.1-6.4年）内，PD组PAF患者CA后无房性心律失常复发存活概率低于非PD组（分别为64.8%和80.3%；P=0.024）。Cox回归分析显示，在调整年龄和性别后，PD是心律失常复发的重要预测因素（风险比：2.063，95%置信区间：1.018-4.182）。
牙周炎与首次PAF患者CA后心律失常复发风险增加独立相关。我们的结果可能表明，牙周状况可能是PAF消融术后结果的一个可改变的决定因素，有必要进行进一步的前瞻性研究。
