Objective Evaluation of Gastroesophageal Reflux Disease in Patients with Paroxysmal Atrial Fibrillation
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Atrial fibrillation (AF) is the most common cardiac arrhythmia. Some evidence shows that gastroesophageal reflux disease (GERD) may be a trigger for paroxysmal AF (PAF). Most of the previous studies that correlated GERD and AF used questionnaires to diagnose GERD, not an objective evaluation. This study aims to evaluate in patients with PAF: (a) accuracy of symptoms to diagnose GERD; (b) prevalence of GERD; and (c) temporal correlation between cardiac arrhythmia and reflux.
Twenty-two patients (59% females, mean age 68 years) with PAF underwent esophageal manometry followed by ambulatory pH monitoring and concurrent Holter. Eight (36%) patients had GERD symptoms. Patients were grouped as GERD+ or GERD− based on the DeMeester score. Temporal correlation between arrhythmia and reflux was recorded.
Six (27%) patients were GERD+. Symptoms had sensitivity and specificity of 50 and 70%, respectively, for the diagnosis of GERD. Episodic AF occurred in one patient only (GERD−). There were 23 episodes of AF during the test with 14% correlation with reflux. Persistent AF during the period of the test was found in five patients (60% GERD+).
Our results show: (a) Symptoms have a low accuracy for the diagnosis of GERD; (b) the prevalence of GERD in patients with PAF is low; and (c) temporal correlation between episodes of reflux and cardiac arrhythmia is low.
ELC participated in acquisition of data, drafting the article, analysis and interpretation of data, the final approval of the version to be published. FAMH involved in conception and design, acquisition of data, analysis and interpretation of data, drafting the article, the final approval of the version to be published. CAVL contributed to conception and design, analysis and interpretation of data, review for intellectual content, the final approval of the version to be published. MGP participated in review for intellectual content and the final approval of the version to be published. FS participated in review for intellectual content and the final approval of the version to be published. AVVDP took part in conception and design, analysis and interpretation of data, the final approval of the version to be published.
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