Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome - The heart to gut connection!

Yeruva Madhu Reddy, Dhssraj Singh, Darbhamulla Nagarajan, Jayasree Pillarisetti, Mazda Biria, Hemant Boolani, Martin Emert, Vineela Chikkam, Kay Ryschon, James Vacek, Sudha Bommana, Donita Atkins, Atul Verma, Mojtaba Olyaee, Buddhadeb Dawn, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Purpose: An association between atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) and/or irritable bowel syndrome (IBS) is increasingly being identified; yet the role of radiofrequency catheter ablation (RFA) of AF has not been systematically evaluated in these patient populations. Methods: We performed a prospective matched case-control study of AF patients with GERD and/or IBS who underwent RFA for AF in two centers in North America. AF patients with GERD and/or IBS (gastrointestinal [GI] group) were matched by age, gender, and type of AF at each of the centers with an equal number of AF patients without GERD or IBS (non-GI group). Results: Sixty patients were included in the study with 30 in each group. Mean age of the population was 45 years with 14 (47 %) males and 21 (87 %) patients with paroxysmal AF in each group. More patients in the GI group had identifiable GI triggers for AF episodes. During RFA, more patients in the GI group had a "vagal response" compared to non-GI group (60 vs 13 %; p < 0.001). Left atrial scar as identified by electroanatomical mapping was more common in patients in the non-GI group compared to the GI group (57 vs 27 %; p = 0.018). At 1-year follow-up, 56 (93 %) of the patients were free from AF with no difference between both groups. Conclusions: Majority of AF patients with GERD and/or IBS have triggered AF and a positive vagal response during RFA. RFA is equally effective in this patient population when compared to those without GERD or IBS.

Original languageEnglish (US)
Pages (from-to)259-265
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
Volume37
Issue number3
DOIs
StatePublished - Sep 2013

Keywords

  • Atrial fibrillation ablation
  • Case-control study
  • Gastroesophageal reflux disease
  • Irritable bowel syndrome
  • Vagal response

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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