Atrial fibrillation or AFib is the most common form of irregular heartbeat, or arrhythmia in the U.S. It can be successfully treated by catheter ablation, a nonsurgical procedure that uses radiofrequency energy to destroy the area of heart tissue causing the arrhythmia.

AFib can recur even after ablation, however. This happens in up to 39 percent of patients, so identifying and addressing risk factors such as controlling weight, blood pressure, alcohol use and smoking for the condition may help improve treatment outcomes.

People who received periodontal treatment were 61 percent less likely to have a recurrence of AFib than those who declined treatment.

Inflamed gums or periodontitis also appear to raise the risk of AFib. Gum disease has been associated with several systemic diseases, but it has not been recognized as a risk factor for AFib.

A recent study may change that. It found that treating periodontal disease in the three-month period after patients with heart arrhythmias received catheter ablation reduced oral inflammation and appeared to also reduce the risk of AFib recurring.

“Proper management of gum disease appears to improve the prognosis of AFib, and many people around the world could benefit from it,” Shunsuke Miyauchi, lead author on the study, said in a statement.

A total of 228 people with AFib were enrolled in the study done over a 28-month period at a single site in Hiroshima, Japan. Sixty-six percent of participants were men and 34 percent were women. Before undergoing catheter ablation, they were examined by a dentist who measured the amount of periodontitis of each using the Periodontal Inflamed Surface Area Index (PISA).

A group of 97 people opted to receive periodontal treatment for severe gum inflammation after they underwent ablation. Another group of 191 people declined to receive treatment.

During a follow-up period of eight-and-a-half months to two years, AFib recurred in 24 percent of all participants. Those who received periodontal treatment were 61 percent less likely to have a recurrence of AFib than those who declined treatment. Participants who had a recurrence of AFib had more severe gum disease than those who did not have a recurrence.

“We were surprised how useful a quantitative measure of gum disease like PISA can be in clinical practice,” Miyauchi said.

There are several other predictors of Afib recurrence: being female, having an irregular heartbeat lasting more than two years and enlargement of the left atrium, one the four chambers of the heart.

Left atrial volume is an important marker of cardiac function. Enlargement can lead to AFib recurrence because it includes thickening and scarring of connective tissues in the heart, Miyauchi, a cardiologist and an assistant professor at Hiroshima University, explained.

The study had some limitations. The sample was small and drawn from a single research center, and patients were not randomized to receive dental treatment. In addition, the periodontal health of those who declined treatment was not followed after the initial exam, and markers of systemic inflammation in the blood were not retested following ablation.

Studies are being designed to pinpoint more precisely how gum inflammation might cause AFib. “We are now doing research to determine the mechanism underlying the relationship between gum disease and AFib,” said Miyauchi. To confirm the findings, a multicenter study with a larger study population is needed, as are studies to determine the best periodontal treatment protocol after catheter ablation.

The study is published in the Journal of the American Heart Association.