Association Between Gastroesophageal Reflux Disease and Atrial Arrhythmias IRAQ-FALLUJAH-2010-2012

Abstract

Introduction Gastroesophageal reflux represents the retrograde flow of gastric contents into the esophagus. It occurs even in healthy individuals and is regarded as "physiological" as long as it does not induce esophageal mucosal abnormalities or symptoms. Whenever Gastro-oesophageal reflux provokes symptoms or complications it is called gastro-oesophageal reflux disease (GERD). In the last decade, there has been renewed interest_in the functional relationship between the gastrointestinal tract " the oesophagus in particular" and the cardiovascular system, there is clinical evidence showing the role of the oesophagus in triggering cardiac dysrhythrnias. As there are cases of atrial arrhythmias with obscure reasons in spite of all sophisticated diagnostic tests, so this research may contributes in detecting one of these reasons. Objective the association between gastroesophageal reflux disease (GERD) and cardiac dysrhythmias still conjectural in spite of studies that had been conducted. By this study I try to explore this relationship and to test the efficacy of proton pump inhibitors on GERD related arrhythmias. Methods Gastroscopy and 24 hrs ECG Holter monitoring performed for 120 patients (67 males and 53 females, The age of study sample ranged between a minimum of 16 years to a maximum of 70 years old. The mean age was 34 + / - ll years) who complained of symptoms of (GERD) with frequency score for symptoms of GERD of 8 and more afier excluded all the n'sk factors that can influenced the heart rate. A second 24 hrs Holter study two month followed treatment "as outpatients" by proton pump inhibitors (PPI), and a third Holter study one month after hold of treatment had been perfonned. Results An impressive reduction in frequency count of atrial arrhythmias were noticed in 68.1% of studied subjects, furthennore, significant recurrence of sinus tachycardia observed in 75% of patients, one month afler discontinuing treatment. Conclusion Atrial arrhythmias can be triggered by GERD, PPI had a significant influence on amelioration of the GERD related atrial arrhythmias.