Atrial fibrillation and gastrooesophageal reflux disease: association mechanisms, treatment approaches

Антропова, О. Н.; Пырикова, Н. В.; Осипова, И. В.

doi:10.15829/1560-4071-2019-7-103-109

Cited by 5 publications

(2 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Пациенты с пароксизмальной желудочковой тахикардией [14] и ГЭРБ имеют целый ряд общих сопутствующих заболеваний: ожирение [15], метаболический синдром, апноэ сна [16]. Ожирение повышает градиент гастроэзофагеального давления [8,17,18]. Лечение ГЭРБ приводит к улучшению сердечных функций [16,19].…”

Section: Discussionunclassified

Rare variant of Remkheld syndrome

Chepurnenko

Nasytko

Shavkuta

2022

jour

View full text Add to dashboard Cite

Introduction. Gastroesophageal reflux disease (GERD) can be accompanied by a triad of cardiac symptoms (arrhythmia, cardialgia, signs of autonomic dysfunction). This syndrome is called gastro-cardiac or Remheld syndrome. The most common rhythm disturbances in Remheld syndrome are atrial fibrillation, supraventricular extrasystole. In the clinical case we have described, a rare variant of Remheld’s syndrome is presented: paroxysmal ventricular tachycardia with GERD.Description of the clinical case. Patient V., 48 years old, applied to a cardiologist on 21.04.21 with complaints of attacks of sudden palpitations, disturbing for six months. From the anamnesis it is known that since 2017 he has been suffering from GERD, he does not take drugs for stopping reflux attacks for 6 months, canceling it on his own. According to Holter ECG monitoring from 03/20/21, paroxysmal ventricular tachycardia was revealed. According to echocardioscopy data from 04/26/21, no structural changes that could be the cause of this life-threatening rhythm disturbance were found. Video gastroscopy from 04/28/21: distal reflux esophagitis. Endoscopic signs of hiatal hernia. Lack of cardia 2 tbsp. Gastroesophageal prolapse. At the consultation with a gastroenterologist, the patient was prescribed both non-drug (lifestyle correction) and drug treatment: rabeprozole, clarithromycin, amoxicillin and others. In addition for the relief of paroxysmal ventricular tachycardia—amiodarone, telmisartan.Discussion. According to studies, one of the mechanisms of arrhythmia in GERD is associated with the excitation of the distal esophagus by refluctate with the development of viscero-visceral reflexes mediated through n. vagus. Increased activation of n. vagus creates an arrhythmogenic substrate for the re-entry mechanism, and thus increases the risk of arrhythmias. Antiarrhythmic therapy along with the treatment of GERD led to the elimination of VT paroxysms. Later, 2 months after the withdrawal of antiarrhythmic drugs against the background of ongoing GERD therapy, paroxysms of VT were not recorded. This was also a confirmation of the pathogenetic relationship between GERD and paroxysmal VT.Conclusion. The case is of interest to the development of a life-threatening rhythm disturbance: paroxysmal ventricular tachycardia against the background of GERD, which is a very rare variant of Remkheld’s syndrome and is not found in the available literature.

show abstract

Section: Discussionunclassified

Rare variant of Remkheld syndrome

Chepurnenko

Nasytko

Shavkuta

2022

jour

View full text Add to dashboard Cite

show abstract

“…The doctrine has also suggested an increase in the number of patients with reflux esophagitis due to an axial hernia of the oesophageal orifice [7]. In addition, there is also a growing subject interest in investigating the dysfunctional relationship between the gastrointestinal tract and the cardiovascular system [8]. The consequences of failing to diagnose and detect this disease in time can be very negative, involving complications that put the patient's life at risk.…”

Section: Research Questionsmentioning

confidence: 99%

Russian legal experience in using information technologies in diagnostics of reflux esophagitis

Voevodina

2021

SHS Web Conf.

View full text Add to dashboard Cite

This publication focuses on a theoretical investigation of the issues of Russian experience in the application of digital technologies in the provision of medical care in the diagnosis of oesophageal hernia complicated by reflux esophagitis. The relevance of the research lies not only in the increasing number of patients diagnosed with reflux esophagitis, but also in the current digital paradigm of the entire Russian healthcare system. Despite domestic legislative attempts to legally regulate the use of digital technologies in health care through the regulatory introduction of telemedicine technology, as is most common, certain issues in the use of this digital "platform" in health care remain unresolved. The methodological basis of this study is the methods of comparative analysis, system-structural analysis and synthesis. The author has assessed the possibility of using telemedicine technologies in the context of the doctor-patient relationship, implemented in a remote format, when diagnosing a patient, including from the position of significant territorial remoteness of the patient. There is a focus on the need for a more specific legal regulation in terms of legally establishing the definition for guaranteeing the security of personal data received by participants in the consultation, processed by them when applying telemedicine technologies.

show abstract

Correction of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm during antireflux operations

et al. 2022

View full text Add to dashboard Cite

Introduction. Hernia of the esophageal opening of the diaphragm in 90% of cases is the main cause of the development of reflux esophagitis. The doctrine highlighted a large group of extraesophageal manifestations of reflux esophagitis, including gastrocardiac syndrome.Аim. The purpose of this publication is to evaluate the effectiveness of antireflux surgery in patients with hiatal hernia through the prism of its effectiveness in the dynamics of gastrocardial syndrome regression.Material and мethods. The paper presents the results of diagnostics and surgical treatment of 101 patients with hiatal hernia.Results. According to the data of instrumental research methods, cardiac hernias of the esophageal opening of the diaphragm were detected in 45 (44.5%) patients, cardiofundal in 40 (39.6%), subtotal in 15 (14.8%), total in 1 (0.9%). The main place in the clinical picture of gastrocardial syndrome was occupied by the pain syndrome behind the breastbone (83.1%). Thus, arrhythmias were found in 16 (40.0%) patients with cardiofundal, in 10 (66.6%) subtotal and in 1 (100.0%) total hiatal hernia, and angina pectoris is characteristic of cardiac hernias and was observed in 20 (44.4%) patients. The clinical manifestation of reflex angina pectoris and arrhythmias depended on the degree of shortening of the esophagus. Thus, arrhythmias were more common in patients with cardiofundal (50.0%), subtotal (71.4%), total (100.0%) hiatal hernia with II degree of shortening of the esophagus, and angina pectoris characteristic of cardiac (75.0%) hiatal hernia. with II degree of shortening of the esophagus. Reflex angina is typical for patients of the older age group, and manifestations of arrhythmia are recorded at a younger age. Heart rate variability was considered, according to electrocardiogram and Holter ECG monitoring before and after surgical treatment, where the parameters significantly (p> 0.05) decreased.Conclusions. The phenomena of gastrocardial syndrome regressed after antireflux surgery in 44 (43.5%) patients. Surgical treatment from the endovideosurgical approach did not worsen the results of surgical treatment.

show abstract

Atrial fibrillation and gastrooesophageal reflux disease: association mechanisms, treatment approaches

Cited by 5 publications

References 52 publications

Rare variant of Remkheld syndrome

Rare variant of Remkheld syndrome

Russian legal experience in using information technologies in diagnostics of reflux esophagitis

Correction of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm during antireflux operations

Contact Info

Product

Resources

About