The duration of AF is used to classify this disorder into different types:
Paroxysmal fibrillation – the heart returns to regular rhythm on its own;
Persistent AF – irregular heart beats lasting longer than 48 hours and will require medications to return to normal sinus rhythm;
Permanent or chronic AF – irregular heart beats that will not return to normal rhythm even with medications.
AF is a type of arrhythmia that is associated with comorbidities (see below) with a high degree of morbidity and mortality.
Severity and stability of these comorbid conditions determine dental management of a patient.
It is estimated that persons with persistent AF have a 5x increased risk to develop a stroke.
|Cardiac disease||Noncardiac disease|
|Reumatic fever, heart failure, valvular heart disease, ventricular function impairment, cardiomyopathy, mitral valve prolapse, thromboembolic events, including angina, myocoardial infarction and stroke, decreased cardiac output, hypertension, hypotension, pulmonary congestion||Acute infection, pulmonary conditions including lung carcinoma, hyperthyroidism, excessive alcohol intake, diabetes|
Signs and symptoms are usually associated with cardiac comorbidities and include dizziness, faintness and confusion, sweating, exercise intolerance, weakness, fatigue, heart palpitations, chest pain, and shortness of breath.
Silent cerebral ischemic events may present as cognitive deficits.
The mainstay of AF therapy is based on prevention of thromboembolic events with anticoagulation therapy and stabilization of the arrhythmia with medications, pacemakers, and defibrillators.
Medications indicate type, severity, and stability of underlying condition(s).
There is an increased mortality rate within 30 days after hospitalization for AF among individuals with AF undergoing even minor surgical procedures.
⚠️ Do not provide elective dental care within 30 days after hospitalization for AF.
- Oral Health Care Considerations