Objective Evaluation of Gastroesophageal Reflux Disease in Patients with Paroxysmal Atrial Fibrillation

• Published in: World journal of surgery Vol. 42; no. 5; pp. 1458 - 1462
• Main Authors: Coutinho, Enia Lucia, Herbella, Fernando A. M., Lovato, Carlos Alexandre Volponi, Patti, Marco G., Schlottmann, Francisco, de Paola, Angelo Amato Vincenzo
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-05-2018; Springer Nature B.V
• Subjects: Abdominal Surgery; Arrhythmia; Cardiac arrhythmia; Cardiac Surgery; Correlation analysis; Diagnosis; Esophagus; Evaluation; Females; Fibrillation; Gastroesophageal reflux; General Surgery; Heart diseases; Medicine; Medicine & Public Health; Original Scientific Report; Patients; pH effects; Surgery; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-017-4337-4

Background
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Some evidence shows that gastroesophageal reflux disease (GERD) may be a trigger for paroxysmal AF (PAF). Most of the previous studies that correlated GERD and AF used questionnaires to diagnose GERD, not an objective evaluation. This study aims to evaluate in patients with PAF: (a) accuracy of symptoms to diagnose GERD; (b) prevalence of GERD; and (c) temporal correlation between cardiac arrhythmia and reflux.
Methods
Twenty-two patients (59% females, mean age 68 years) with PAF underwent esophageal manometry followed by ambulatory pH monitoring and concurrent Holter. Eight (36%) patients had GERD symptoms. Patients were grouped as GERD+ or GERD− based on the DeMeester score. Temporal correlation between arrhythmia and reflux was recorded.
Results
Six (27%) patients were GERD+. Symptoms had sensitivity and specificity of 50 and 70%, respectively, for the diagnosis of GERD. Episodic AF occurred in one patient only (GERD−). There were 23 episodes of AF during the test with 14% correlation with reflux. Persistent AF during the period of the test was found in five patients (60% GERD+).
Conclusions
Our results show: (a) Symptoms have a low accuracy for the diagnosis of GERD; (b) the prevalence of GERD in patients with PAF is low; and (c) temporal correlation between episodes of reflux and cardiac arrhythmia is low.