Key result
High P. gingivalis type IV IgG predicts ~94% higher late AF recurrence risk post-ablation.
Why the study?
Inflammation is a main cause of AF recurrence after ablation, and Porphyromonas gingivalis is a key periodontal pathogen reflecting periodontitis status, prompting investigation into whether serum IgG titers against P. gingivalis relate to late recurrence after RFCA.
Does high serum IgG antibody titer against Porphyromonas gingivalis predict late recurrence of atrial fibrillation after radiofrequency catheter ablation?
Cohort (n=596)
Does high serum IgG antibody titer against Porphyromonas gingivalis predict late recurrence of atrial fibrillation after radiofrequency catheter ablation?
High serum antibody titers against Porphyromonas gingivalis type IV are independently associated with an increased risk of late atrial fibrillation recurrence after radiofrequency catheter ablation.
Answers are grounded in this paper and cite their sources.
High titers should not prompt changes in post-ablation AF care; leaves open whether periodontal pathogens contribute to recurrence.
INTRODUCTION: Inflammation is one of the main causes of atrial fibrillation (AF) recurrence after ablation. Porphyromonas gingivalis is a key periodontal pathogen in the oral-systemic disease connection and serum immunoglobulin G (IgG) antibody titers against P. gingivalis reflect the clinical status of periodontitis. This study aimed to investigate the relationship between late recurrence of AF after radiofrequency catheter ablation (RFCA) and serum IgG antibody titers against P. gingivalis. METHODS: A total of 596 AF patients (mean age, 64.9 ± 10.0 years; 69% male; 61% paroxysmal AF) who underwent a first session of RFCA were enrolled. Patients were carefully examined for late recurrence during a mean follow-up period of 17.1 ± 14.5 months. Serum IgG antibody titers against P. gingivalis (types I-IV) were measured using enzyme-linked immunosorbent assay. The results of serum antibody titers were divided into a high-value and a low-value group. RESULTS: Among the five P. gingivalis subtypes, serum antibody titer against P. gingivalis type IV was associated with late recurrence (odds ratio, 1.937; 95% confidence interval [CI], 1.301-2.884; p = .002). Multivariate Cox proportional-hazards regression analysis revealed that high-value serum antibody titer against P. gingivalis type IV independently predicted late recurrence (paroxysmal AF: adjusted hazard ratio [HR], 1.569; 95% CI, 1.010-2.427; p = .04; non-paroxysmal AF: adjusted HR, 1.909; 95% CI, 1.213-3.005; p = .004). CONCLUSION: Periodontitis was related to the late recurrence of AF after RFCA. P. gingivalis type IV may be pathogenic for AF recurrence after RFCA.
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Miyauchi et al. (2021) conducted a cohort in Atrial fibrillation (n=596). High serum IgG antibody titer against P. gingivalis type IV vs. Low serum IgG antibody titer against P. gingivalis type IV was evaluated on Late recurrence of atrial fibrillation (OR 1.937, 95% CI 1.301-2.884, p=0.002). High serum IgG antibody titers against P. gingivalis type IV independently predicted late recurrence of atrial fibrillation after ablation (OR 1.937; 95% CI 1.301-2.884; p=0.002).
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