Best Practice Case Studies-Case 127 Asset 3 Gastroesophageal Reflux in Athletes

Pdf Summary

This traditional review examines a possible association between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF). The authors note that both conditions are common, often coexist in clinical practice, and share risk factors such as obesity, sleep apnea, aging, smoking, alcohol use, and inflammation. Although a definitive causal mechanism has not been established, the review proposes several pathways by which GERD might contribute to AF.<br /><br />Key proposed mechanisms include inflammation from acid reflux, which may affect nearby cardiac tissue and the autonomic nervous system, especially the vagal nerves. The review also discusses sympathovagal imbalance as a trigger for AF, particularly paroxysmal AF. In addition, vigorous exercise can provoke reflux in athletes, potentially linking exercise-induced GERD with arrhythmias. Another factor is hiatal hernia, which may worsen reflux and, in large cases, mechanically compress the left atrium, possibly promoting AF.<br /><br />The paper highlights evidence that proton pump inhibitors (PPIs), commonly used to treat GERD, have in some reports reduced AF symptoms or recurrence. The authors suggest that PPIs may help not only by lowering acid exposure but also through anti-inflammatory and antioxidant effects. However, they emphasize that existing evidence is limited mostly to case reports and observational studies.<br /><br />Overall, the review concludes that GERD and AF are plausibly linked, with esophageal inflammation being the most supported connection. Still, the exact mechanism remains unclear, and more rigorous studies are needed to determine whether GERD is a true risk factor for AF and whether treating reflux can reliably improve arrhythmia outcomes.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 127

Topic Gastrointestinal

Keywords

gastroesophageal reflux disease

atrial fibrillation

esophageal inflammation

acid reflux

vagal nerve

sympathovagal imbalance

hiatal hernia

proton pump inhibitors

arrhythmia

inflammation

4th Edition

4th Edition, Case 127

Gastrointestinal