GERD Linked to Lone Paroxysmal Atrial Fibrillation

[Guest guest]

GERD Linked to Lone Paroxysmal Atrial Fibrillation

Laurie

Barclay, MD

Dec.

12, 2003 — Gastroesophageal reflux disease (GERD) may be a causal

factor for lone paroxysmal atrial fibrillation (PAF),

according to the results of a pilot study published in the November issue of

the Southern Medical Journal. The

investigators suggest that GERD should be investigated as a potential pathogenetic mechanism of lone PAF.

" Clinical observations and a case report in

the literature suggest that GERD may induce atrial

fibrillation and that therapy of GERD decreases the frequency of attacks of

PAF, " write a Weigl, MD, and colleagues

from the Krankenanstalt Rudolfstiftung

in Vienna, Austria. " Since proton pump inhibitors (PPIs)

have fewer side effects and are less expensive than antiarrhythmic

drugs or electrotherapy, therapy of GERD in patients with PAF might be an

attractive alternative to the conventional and often not completely successful

therapy of PAF. "

Record review of 89 patients with reflux esophagitis revealed that 18 had lone PAF, including six

women. Age range was 39 to 69 years.

After PPI therapy, 14 (78%) of 18 patients

experienced a decrease or the disappearance of at least one PAF-related

symptom, and all had sinus rhythm on follow-up electrocardiogram. None of the

patients required an increase in dose or addition of antiarrhythmic

drugs, and five patients were able to discontinue their antiarrhythmic

drugs.

In two of the four patients who did not show

improvement in PAF symptoms after PPI therapy was started, GERD-related

symptoms persisted.

Study limitations include small number of

patients, the retrospective design, the lack of a control group, and possible

placebo effect

" In lone PAF, GERD should be investigated

as a potential pathogenetic mechanism, " the

authors write. " PPI therapy reduces not only GERD-related but also

PAF-related symptoms. "

Much

Love,

Deanna

LUPUS

Serenity Prayer...

Lord, grant me the

serenity to accept the things I cannot change, the courage to change the things

I can, and the wisdom to hide the bodies of doctors I shot when they said,

You're perfectly healthy, it's all in your head "