Atrial Fibrillation and Acid Reflux Disease

Abstract

To date, the precise mechanism of atrial fibrillation (AF) as a possible cause of reflux disease remains uncertain, although some possibilities can be postulated. Inflammation and vagal stimulation may have a key role linking these 2 common diseases. There is some evidence in the form of case reports and limited observational studies reporting that reflux disease, and more specifically esophagitis, can cause paroxysmal AF, and various mechanisms have been proposed. Some studies have demonstrated that acid suppressive therapy by proton pump inhibitors (PPIs) may help ameliorate symptoms associated with AF and also facilitate conversion to normal sinus rhythm in a subset of patients. Further prospective studies are needed to determine if a true causal mechanism exists between the two and assess whether the mechanism is dependent on a specific subtype of AF. In addition, the response of AF‐related symptoms to PPI therapy and the potential for PPI therapy to reduce the development of AF merits further investigation. Clin. Cardiol. 2011 DOI: 10.1002/clc.21969The authors have no funding, financial relationships, or conflicts of interest to disclose.

Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease

“…Finally, there is evidence that chronic GERD may induce an autoimmune response that contributes to cardiac dysrhythmias, especially atrial fibrillation [17] . As a confirmation of their statement, in this clinical study, all analyzed parameters of shortterm analysis of RR variability had significantly lower values in GERD patients than in the control group.…”

Gastroesophageal reflux disease is a predictor of atrial fibrillation recurrence following left atrial ablation

“…This is the first study showing that GERD is an independent predictor of AF recurrence after LA ablation for paroxysmal AF. An association between GERD and increased risk of AF development has been previously established [1,2]. Chronic inflammation and autonomic imbalance have been proposed as plausible pathophysiological mechanisms of GERD-induced AF [1,2].…”

“…An association between GERD and increased risk of AF development has been previously established [1,2]. Chronic inflammation and autonomic imbalance have been proposed as plausible pathophysiological mechanisms of GERD-induced AF [1,2]. Acid reflux causes a local inflammation of the esophageal mucosa that may affect the adjacent vagal nerves and the local receptors inducing afferent-efferent reflex mechanisms [8,9].…”

“…A potential association between GERD and atrial fibrillation (AF) development has been proposed in previous studies, mainly attributed to the close positioning of the esophagus and the left atrium [1,2]. Previous studies have demonstrated a high incidence of pathologic reflux following left atrial (LA) ablation [3,4].…”

“…Gastroesophageal reflux disease (GERD) is the most common gastrointestinal diagnosis made during visits to outpatient clinics [1,2]. A potential association between GERD and atrial fibrillation (AF) development has been proposed in previous studies, mainly attributed to the close positioning of the esophagus and the left atrium [1,2].…”