title: Atrial fibrillation in patients with gastroesophageal reflux disease: a comprehensive review.
abstract: OBJECTIVE
  To analyze the potential relationship between gastroesophageal reflux disease (GERD) and the development of atrial fibrillation (AF).
  
  
  METHODS
  Using the key words "atrial fibrillation and gastroesophageal reflux", "atrial fibrillation and esophagitis, peptic", "atrial fibrillation and hernia, hiatal" the PubMed, EMBASE, Cochrane Library, OVIDSP, WILEY databases were screened for relevant publications on GERD and AF in adults between January 1972-December 2013. Studies written in languages other than English or French, studies not performed in humans, reviews, case reports, abstracts, conference presentations, letters to the editor, editorials, comments and opinions were not taken into consideration. Articles treating the subject of radiofrequency ablation of AF and the consecutive development of GERD were also excluded.
  
  
  RESULTS
  Two thousand one hundred sixty-one titles were found of which 8 articles met the inclusion criteria. The presence of AF in patients with GERD was reported to be between 0.62%-14%, higher compared to those without GERD. Epidemiological data provided by these observational studies showed that patients with GERD, especially those with more severe GERD-related symptoms, had an increased risk of developing AF compared with those without GERD, but a causal relationship between GERD and AF could not be established based on these studies. The mechanisms of AF as a consequence of GERD remain largely unknown, with inflammation and vagal stimulation playing a possible role in the development of these disorders. Treatment with proton pomp inhibitors may improve symptoms related to AF and facilitate conversion to sinus rhythm.
  
  
  CONCLUSIONS
  Although links between AF and GERD exist, large randomized clinical studies are required for a better understanding of the relationship between these two entities.
authors: Crina Roman, Dan L Dumitrascu, Division of Internal Medicine, Second Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
authors: Crina
authors: C
authors: Roman
authors: Crina Roman, Dan L Dumitrascu, Division of Internal Medicine, Second Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
authors: Stanislas
authors: S
authors: Bruley des Varannes
authors: Crina Roman, Dan L Dumitrascu, Division of Internal Medicine, Second Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
authors: Lucian
authors: L
authors: Muresan
authors: Crina Roman, Dan L Dumitrascu, Division of Internal Medicine, Second Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
authors: Alina
authors: A
authors: Picos
authors: Crina Roman, Dan L Dumitrascu, Division of Internal Medicine, Second Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
authors: Dan L
authors: DL
authors: Dumitrascu
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000889:Anti-Arrhythmia Agents; D054328:Proton Pump Inhibitors
keywords: Atrial fibrillation; Esophagitis; Gastroesophageal reflux disease; Pathophysiology; Proton pump inhibitors