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

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

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.

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Conflict of interest

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 Olayee, and Buddhadeb Dawn have no conflicts of interest to declare. Dhanunjaya Lakkireddy received a modest speaker’s honorarium from Boehringer Ingelheim, Janssen, and St. Jude Medical.

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Authors and Affiliations

  1. Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital and Medical Center, Kansas City, KS, USA

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

  2. Division of Gastroenterology, University of Kansas Hospital and Medical Center, Kansas City, KS, USA

    Mojtaba Olyaee

  3. Ryschon Consulting LLC, Omaha, NE, USA

    Kay Ryschon

  4. Southlake Regional Hospital, Southlake, ON, Canada

    Atul Verma

  5. Center for Excellence in Atrial Fibrillation/Complex Arrhythmia Management, Bloch Heart Rhythm Center at University of Kansas Hospital, Electrophysiology Research, KU Cardiovascular Research Institute, 3901 Rainbow Boulevard MS 4023, Kansas City, KS, 66160-7200, USA

    Dhanunjaya Lakkireddy

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  1. Yeruva Madhu Reddy
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Correspondence to Dhanunjaya Lakkireddy.

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Reddy, Y.M., Singh, D., Nagarajan, D. et al. Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome—the heart to gut connection!. J Interv Card Electrophysiol 37, 259–265 (2013). https://doi.org/10.1007/s10840-013-9807-5

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  • DOI: https://doi.org/10.1007/s10840-013-9807-5

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