Paroxysmal Postprandial Atrial Fibrilation Suppressed by Laparoscopic Repair of a Giant Paraesophageal Hernia Compressing the Left Atrium

Abstract

We present the case of a patient with a giant paraesophageal hernia associated with paroxysmal postprandial atrial fibrillation that was suppressed after surgery. The imaging investigations showed the intrathoracic displacement of a large part of the stomach, which pushed the left atrial wall causing atrial fibrillation. The laparoscopic surgical repair acted as sole treatment for this condition.

Posterior cardiac compression from a large hiatal hernia—A novel cause of ventricular tachycardia

“… 5 Similarly, there have been case reports of atrial flutter, 6 junctional bradycardias, 7 anterior T-wave inversion, 8 and ST elevation that have resolved post hernia repair or even after initiation of anti-reflux therapy. 9 , 10 …”

Hiatal hernia as a rare cause of cardiac complications – case based review of the literature

“…Hiatal hernia and changes in electrocardiogram. Changes in the electrocardiogram pattern and rhythm have been observed in patients with hiatal hernias [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. However, the linkage between these conditions has not been fully elucidated.…”

“…In most cases, electrocardiographic alternation disappeared after initial stomach decompression or surgical correction of the hiatal hernia [18,20,21,[30][31][32][33][34][35], or after successful conservative management with dietary control and proton pump inhibitor [29]. Resolution of abnormal findings in ECG after management of hiatal hernia may imply a causal relationship between the hiatal hernia and changes in the electrocardiogram pattern and rhythm.…”

Association of atrial fibrillation and gastroesophageal reflux disease: Natural and therapeutic linkage of the two common diseases

“…Mechanical contact and irritation by hernia on the LA or pulmonary veins (PV) potentially contributes to the ectopic firing leading to the AF burden in patients with hiatus hernia. Actually, some cases of paroxysmal AF treated successfully by repair of associated hernia were reported . Further, Roy et al investigated the prevalence of AF in patients with hernia in comparison with general population from 1976 to 2006 at Mayo Clinic in Rochester, Minnesota.…”