International Journal of Cardiology 198 (2015) 31

Contents lists available at ScienceDirect

International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard

Invited Letter to the Editor

Gastroesophageal reflux disease and atrial fibrillation Konstantinos P. Letsas ⁎, Michael Efremidis, Antonios Sideris Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, “Evangelismos” General Hospital of Athens, Athens, Greece

a r t i c l e

i n f o

Article history: Received 15 May 2015 Accepted 17 May 2015 Available online 2 July 2015 Keywords: Gastroesophageal reflux disease Atrial fibrillation

or by the presence of GERD that is found in most cases of hiatal hernia is unclear. In a large population study, 5.3% of patients with hiatal hernia displayed concomitant AF [5]. An association between GERD and increased risk of AF development has been also established [6]. It is therefore quite possible that both hiatal hernia and GERD are implicated in the pathogenesis of AF. Further studies are needed to validate this interesting topic.

Conflict of interest

To the Editor We would like to thank in advance Dr. Duygu for his interest in our study [1]. We showed that gastroesophageal reflux disease (GERD) was an independent predictor of atrial fibrillation (AF) recurrence after left atrial ablation for paroxysmal AF. Dr. Duygu points out hiatal hernia as a cause of GERD in a patient with persistent AF resistant to pharmacological and direct current cardioversion who converted to sinus rhythm with proton pump inhibitor (PPI) therapy [2]. We reviewed our patients' records and small hiatal hernias were detected in 4 out of 8 patients who underwent endoscopic screening indicating an association between hiatal hernias and GERD. Approximately 60% of individuals aged 50 years or older have a hiatal hernia [3]. Individuals with a hiatal hernia may have GERD possibly due to the trapping of gastric contents in the hernia sac. The trapped gastric contents regurgitate into the esophagus when the lower esophageal sphincter relaxes [4]. Whether AF is caused by the compression of the hiatal hernia on the left atrium

⁎ Corresponding author at: Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, 10676 Athens, Greece. E-mail address: [email protected] (K.P. Letsas).

http://dx.doi.org/10.1016/j.ijcard.2015.05.189 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.

The authors report no relationships that could be construed as a conflict of interest.

References [1] L. Lioni, K.P. Letsas, M. Efremidis, K. Vlachos, D. Karlis, D. Asvestas, et al., Gastroesophageal reflux disease is a predictor of atrial fibrillation recurrence following left atrial ablation, Int. J. Cardiol. 183 (2015) 211–213. [2] H. Duygu, Gastroesophageal reflux and atrial fibrillation: a chicken and egg situation, Int. J. Cardiol. 190 (2015) 241. [3] J.J. Hyun, Y.T. Bak, Clinical significance of hiatal hernia, Gut Liver 5 (2011) 267–277. [4] N.S. Buttar, G.W. Falk, Pathogenesis of gastroesophageal reflux and Barrett esophagus, Mayo Clin. Proc. 76 (2001) 226–234. [5] R.R. Roy, S. Sagar, T.J. Bunch, W. Aman, D.J. Crusan, K. Srivathsan, et al., Hiatal hernia increases the risk of atrial fibrillation in young patients, Heart Rhythm. 7 (Suppl. 5) (2010) S87. [6] C.C. Huang, W.L. Chan, J.C. Luo, Y.C. Chen, T.J. Chen, C.M. Chung, et al., Gastroesophageal reflux disease and atrial fibrillation: a nationwide population-based study, PLoS One 7 (2012) e47575.

Gastroesophageal reflux disease and atrial fibrillation.

Gastroesophageal reflux disease and atrial fibrillation. - PDF Download Free
129KB Sizes 0 Downloads 20 Views