title: Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome-the heart to gut connection!
abstract: OBJECTIVE
  An association between atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) and/or irritable bowel syndrome (IBS) is increasingly being identified; yet the role of radiofrequency catheter ablation (RFA) of AF has not been systematically evaluated in these patient populations.
  
  
  METHODS
  We performed a prospective matched case-control study of AF patients with GERD and/or IBS who underwent RFA for AF in two centers in North America. AF patients with GERD and/or IBS (gastrointestinal [GI] group) were matched by age, gender, and type of AF at each of the centers with an equal number of AF patients without GERD or IBS (non-GI group).
  
  
  RESULTS
  Sixty patients were included in the study with 30 in each group. Mean age of the population was 45 years with 14 (47 %) males and 21 (87 %) patients with paroxysmal AF in each group. More patients in the GI group had identifiable GI triggers for AF episodes. During RFA, more patients in the GI group had a "vagal response" compared to non-GI group (60 vs 13 %; p < 0.001). Left atrial scar as identified by electroanatomical mapping was more common in patients in the non-GI group compared to the GI group (57 vs 27 %; p = 0.018). At 1-year follow-up, 56 (93 %) of the patients were free from AF with no difference between both groups.
  
  
  CONCLUSIONS
  Majority of AF patients with GERD and/or IBS have triggered AF and a positive vagal response during RFA. RFA is equally effective in this patient population when compared to those without GERD or IBS.
authors.affiliation: Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital and Medical Center, Kansas City, KS, USA.
authors.forename: Yeruva Madhu
authors.initials: YM
authors.lastname: Reddy
authors.forename: Dhssraj
authors.initials: D
authors.lastname: Singh
authors.forename: Darbhamulla
authors.initials: D
authors.lastname: Nagarajan
authors.forename: Jayasree
authors.initials: J
authors.lastname: Pillarisetti
authors.forename: Mazda
authors.initials: M
authors.lastname: Biria
authors.forename: Hemant
authors.initials: H
authors.lastname: Boolani
authors.forename: Martin
authors.initials: M
authors.lastname: Emert
authors.forename: Vineela
authors.initials: V
authors.lastname: Chikkam
authors.forename: Kay
authors.initials: K
authors.lastname: Ryschon
authors.forename: James
authors.initials: J
authors.lastname: Vacek
authors.forename: Sudha
authors.initials: S
authors.lastname: Bommana
authors.forename: Donita
authors.initials: D
authors.lastname: Atkins
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Olyaee
authors.forename: Buddhadeb
authors.initials: B
authors.lastname: Dawn
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D002170:Canada / Q000453:epidemiology; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology