Atrial fibrillation and acid reflux disease.
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.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53705, USA.
Poonam
P
Velagapudi
Mohit K
MK
Turagam
Miguel A
MA
Leal
Abraham G
AG
Kocheril
D001281:Atrial Fibrillation / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans