Triggering A-Fib at the Dentist: My Post-Ablation Experience

A while back we published a warning by Dr. Sam about how your dentist’s use of local anesthesia containing epinephrine can trigger your A-Fib. I have another warning to add.

My Dental Cleaning After Catheter Ablation

I was reminded of Dr. Sam’s post when I visited my own dentist three days after having my recent catheter ablation (my Atrial Fibrillation returned after 21 years of being A-Fib free).

No-no-no-ultrasonic dental cleaning for me

Upon hearing of my medical procedure, my long-time dentist, Dr. Dave Famili, didn’t want to use the typical ultrasonic type of dental cleaning because it could disrupt my heart rhythm. So, they didn’t use anything electronic. Instead, they did a manual cleaning only, and all was good.

For my chart, he also requested the name and contact information for my EP, Dr. Shepal Doshi, in case he needed to be contacted.

Update Your Medical Records

From my first-hand experience, I remind you to be sure to inform your dentist and other healthcare providers when you have a procedure for your Atrial Fibrillation.

Use of Epinephrine Could Trigger Your A-Fib 

Another concern at the dentist is the use of Epinephrine (Epi or Adrenalin). It is one of the drugs EPs can use when completing a catheter ablation—they try to trigger A-Fib to check that their ablation scars for working. So any local anesthesia with Epinephrine (Epi) potentially can trigger A-Fib.

Local anesthesia (with Epi or Adrenalin) is used by dentists, dermatologists, emergency room personnel and others.

At the Dentist: A retired MD wrote to caution A-Fib patients that local anesthesia containing epinephrine can trigger your A-Fib.

Dr. Sam writes: “I had to have a dental implant and bridgework requiring that I have local anesthesia several times. The dentist uses local anesthesia with Epinephrine (Epi or Adrenalin) to numb your mouth. 

My EP said he thought it would be OK to use. So I had it, and within 30 minutes I was in A-Fib which lasted about 20 minutes and then I went back into NSR.

From then on I requested that my dentist use only local anesthesia without Epi, and I had no more A-Fib episodes. Dentists like to use local anesthesia with Epi because it lasts longer and reduces bleeding locally.

I found very little info online about this, and no studies had been done about dental anesthesia with Epi & A-Fib.”

Tell Your Doctors: Epinephrine Containing Products Can Trigger Your A-Fib

At the Ophthalmologist: The drops that the eye doctor uses to dilate your eyes are similar to Adrenalin. Ask for an alternative.

At the Dermatologist: Local anesthesia containing epinephrine is used by your doctor to numb skin and reduce bleeding when they remove cysts, lipomas, moles, skin cancer spots, etc. and to close lacerations. Tell them your concern about triggering your A-Fib.

Your GP and at the Emergency Room: Doctors use local anesthesia with Epinephrine to sew up wounds and/or to do small surgical procedures requiring local anesthesia, because it reduces bleeding locally and lasts longer. Remind your GP and discuss your A-Fib with emergency room caregivers. Express your concern about the use of Epinephrine. Ask for an alternative.

Are You Allergic to Medications? As a Caution Include Epinephrine

Allergic to any medications?

Medical staff routinely ask if you are allergic to any medications.

Tell your doctors you have Atrial Fibrillation and discuss your concern that the use of local anesthesia with Epinephrine may trigger your Atrial Fibrillation.

You might want to add Epinephrine as a medication you are allergic to in your medical records along with an explanation.