Relationship between Atrial Fibrillation and Gastroesophageal Reflux Disease: A Multicenter Questionnaire Survey

Abstract

Objectives: The relationship between atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) remains controversial, and investigations into this relationship have been based on small series. This multicenter survey evaluated the relationship between these diseases. Methods: The study enrolled 188 consecutive subjects (110 males and 78 females, mean age 60.4 ± 0.9 years) treated as outpatients. Patients were classified by the frequency scale for symptoms of GERD (F-scale) after obtaining informed consent for screening for GERD. Scores on this questionnaire were correlated to baseline characteristics obtained from medical records. The cutoff value for a diagnosis of GERD was set at 8.0 points. Results: Total scores on the F-scale were significantly greater in female subjects (p = 0.004) and in patients with AF (p = 0.019) compared to the other subjects. Univariate and multivariate analysis of the prevalence of GERD demonstrated that GERD was not related to gender, hypertension, dyslipidemia or coronary artery disease and that AF alone showed a significant (p < 0.001) correlation with GERD. Conclusions: This multicenter questionnaire survey demonstrated that among traditional cardiovascular risk factors, AF was an independent risk factor for GERD. A large cohort study to assess the potential relationship between GERD and AF is warranted.

Atrial Fibrillation and Acid Reflux Disease

“…In addition, due to the cross-sectional nature of the data, patients were not followed over time to evaluate if this finding was causative or correlative. Another recent multicenter questionnaire survey by Shimazu et al in 2011 36 enrolled 188 consecutive subjects (110 males and 78 females; mean age, 60.4 ± 0.9 years) treated as outpatients. Patients were classified by the frequency scale for symptoms of GERD (F scale).…”

Upper Gastrointestinal Symptoms and Cardiovascular Disease

“…In addition to the aforementioned data suggesting upper gastrointestinal symptoms are more prevalent with patients with cardiovascular diseases; a body of literature suggesting upper gastrointestinal symptoms may in fact induce cardiovascular disease has begun to take shape [15][16][17][18]. In 2003, the first signal that gastro esophageal-like symptoms or disease could be linked to the development of atrial fibrillation was published [15].…”

“…Since that time, 3 observational studies [16][17][18] The second study [17] similarly sought to assess the relationship between gastroesophageal reflux disease and atrial fibrillation; and the researchers assessed the risk for atrial fibrillation over a follow-up period of greater than 11 years. A self-report survey was sent to 5,288 patients aged 25-74 over the 6 year period of 1988-1994.…”

“…Finally, the most recently published study assessed the relationship between atrial fibrillation and gastroesophageal reflux disease in 188 Japanese patients between 28-91 years of age [18].…”

“…The finding of higher prevalence rates of upper gastrointestinal symptoms in patients with cardiovascular disease may exist for a number of reasons. First, there are a host of mutual risk factors for developing both cardiovascular disease and upper gastrointestinal symptoms [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Next, patients experiencing both health problems often complain of similar or overlapping symptomatology, potentially resulting in the more frequent surveillance and diagnosis of both [38].…”