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Long-Term Risk of Atrial Fibrillation With Symptomatic Gastroesophageal Reflux Disease and Esophagitis
The mechanisms underlying the triggers and maintenance of atrial fibrillation (AF) are not fully understood. One potential unproved mechanism is that gastroesophageal reflux disease (GERD), in which acid reflux induces local and systemic inflammation, may increase triggered activity in the myocardiu...
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| Published in: | The American journal of cardiology 2008-11, Vol.102 (9), p.1207-1211 |
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| creator | Bunch, T. Jared, MD Packer, Douglas L., MD Jahangir, Arshad, MD Locke, G. Richard, MD Talley, Nicholas J., MD, PhD Gersh, Bernard J., MBChB, DPhil Roy, Ranjini R., MD Hodge, David O., MS Asirvatham, Samuel J., MD |
| description | The mechanisms underlying the triggers and maintenance of atrial fibrillation (AF) are not fully understood. One potential unproved mechanism is that gastroesophageal reflux disease (GERD), in which acid reflux induces local and systemic inflammation, may increase triggered activity in the myocardium and pulmonary veins and increase AF risk. A self-report questionnaire was mailed to a random sample of 5,288 residents of Olmsted County, Minnesota, aged 25 to 74 years to assess the presence and frequency of GERD from 1988 to 1994. The long-term risk for AF over a period of 11.4 ± 5.0 years was determined through review of clinical evaluations and the electrocardiographic database in those without previous AF. The average age was 53 ± 17 years, and 2,571 subjects (49%) were man. Of these patients, 741 developed AF (cumulative probability of AF at 18 years 20%, 95% confidence interval [CI] 17% to 22%). Age (hazard ratio [HR] 1.09, 95% CI 1.08 to 1.10, p |
| doi_str_mv | 10.1016/j.amjcard.2008.06.048 |
| format | article |
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Jared, MD ; Packer, Douglas L., MD ; Jahangir, Arshad, MD ; Locke, G. Richard, MD ; Talley, Nicholas J., MD, PhD ; Gersh, Bernard J., MBChB, DPhil ; Roy, Ranjini R., MD ; Hodge, David O., MS ; Asirvatham, Samuel J., MD</creator><creatorcontrib>Bunch, T. Jared, MD ; Packer, Douglas L., MD ; Jahangir, Arshad, MD ; Locke, G. Richard, MD ; Talley, Nicholas J., MD, PhD ; Gersh, Bernard J., MBChB, DPhil ; Roy, Ranjini R., MD ; Hodge, David O., MS ; Asirvatham, Samuel J., MD</creatorcontrib><description>The mechanisms underlying the triggers and maintenance of atrial fibrillation (AF) are not fully understood. One potential unproved mechanism is that gastroesophageal reflux disease (GERD), in which acid reflux induces local and systemic inflammation, may increase triggered activity in the myocardium and pulmonary veins and increase AF risk. A self-report questionnaire was mailed to a random sample of 5,288 residents of Olmsted County, Minnesota, aged 25 to 74 years to assess the presence and frequency of GERD from 1988 to 1994. The long-term risk for AF over a period of 11.4 ± 5.0 years was determined through review of clinical evaluations and the electrocardiographic database in those without previous AF. The average age was 53 ± 17 years, and 2,571 subjects (49%) were man. Of these patients, 741 developed AF (cumulative probability of AF at 18 years 20%, 95% confidence interval [CI] 17% to 22%). Age (hazard ratio [HR] 1.09, 95% CI 1.08 to 1.10, p <0.001), male gender (HR 1.81, 95% CI 1.53 to 2.14, p <0.001), hypertension (HR 1.36, 95% CI 1.14 to 1.61, p = 0.0006), and heart failure (HR 1.74, 95% CI 1.16 to 2.60, p = 0.007) were independently associated with the risk of AF. The presence of any GERD was not associated with risk for AF (HR 0.81, 95% CI 0.68 to 0.96, p = 0.014) after adjustment for other risk factors. The frequency of GERD did not significantly affect the risk for AF, although patients with more frequent GERD had a slightly higher AF risk. Esophagitis increased the risk for AF (HR 1.94, 95% CI 1.35 to 2.78, p <0.001), but the association did not persist when accounting for other risk factors (p = 0.72). In conclusion, in this large population-based study of patients surveyed for GERD, no association was found with the presence or frequency of symptoms and AF. Patients with esophagitis were more likely to develop AF, although this association requires further study.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2008.06.048</identifier><identifier>PMID: 18940293</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - etiology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular system ; Electrocardiography ; Esophagitis - complications ; Esophagus ; Female ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastroesophageal reflux ; Gastroesophageal Reflux - complications ; Health risk assessment ; Heart ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Risk Factors ; Surveys and Questionnaires ; Time Factors</subject><ispartof>The American journal of cardiology, 2008-11, Vol.102 (9), p.1207-1211</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Nov 1, 2008</rights><rights>2009 Excerpta Medica, Inc. All rights reserved. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c577t-7f3830bcaa4b63be0cb0a5944c81b04e02fb99054f85e4ff4c655d547b03b24a3</citedby><cites>FETCH-LOGICAL-c577t-7f3830bcaa4b63be0cb0a5944c81b04e02fb99054f85e4ff4c655d547b03b24a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20841241$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18940293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bunch, T. Jared, MD</creatorcontrib><creatorcontrib>Packer, Douglas L., MD</creatorcontrib><creatorcontrib>Jahangir, Arshad, MD</creatorcontrib><creatorcontrib>Locke, G. Richard, MD</creatorcontrib><creatorcontrib>Talley, Nicholas J., MD, PhD</creatorcontrib><creatorcontrib>Gersh, Bernard J., MBChB, DPhil</creatorcontrib><creatorcontrib>Roy, Ranjini R., MD</creatorcontrib><creatorcontrib>Hodge, David O., MS</creatorcontrib><creatorcontrib>Asirvatham, Samuel J., MD</creatorcontrib><title>Long-Term Risk of Atrial Fibrillation With Symptomatic Gastroesophageal Reflux Disease and Esophagitis</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The mechanisms underlying the triggers and maintenance of atrial fibrillation (AF) are not fully understood. One potential unproved mechanism is that gastroesophageal reflux disease (GERD), in which acid reflux induces local and systemic inflammation, may increase triggered activity in the myocardium and pulmonary veins and increase AF risk. A self-report questionnaire was mailed to a random sample of 5,288 residents of Olmsted County, Minnesota, aged 25 to 74 years to assess the presence and frequency of GERD from 1988 to 1994. The long-term risk for AF over a period of 11.4 ± 5.0 years was determined through review of clinical evaluations and the electrocardiographic database in those without previous AF. The average age was 53 ± 17 years, and 2,571 subjects (49%) were man. Of these patients, 741 developed AF (cumulative probability of AF at 18 years 20%, 95% confidence interval [CI] 17% to 22%). Age (hazard ratio [HR] 1.09, 95% CI 1.08 to 1.10, p <0.001), male gender (HR 1.81, 95% CI 1.53 to 2.14, p <0.001), hypertension (HR 1.36, 95% CI 1.14 to 1.61, p = 0.0006), and heart failure (HR 1.74, 95% CI 1.16 to 2.60, p = 0.007) were independently associated with the risk of AF. The presence of any GERD was not associated with risk for AF (HR 0.81, 95% CI 0.68 to 0.96, p = 0.014) after adjustment for other risk factors. The frequency of GERD did not significantly affect the risk for AF, although patients with more frequent GERD had a slightly higher AF risk. Esophagitis increased the risk for AF (HR 1.94, 95% CI 1.35 to 2.78, p <0.001), but the association did not persist when accounting for other risk factors (p = 0.72). In conclusion, in this large population-based study of patients surveyed for GERD, no association was found with the presence or frequency of symptoms and AF. Patients with esophagitis were more likely to develop AF, although this association requires further study.</description><subject>Adult</subject><subject>Aged</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - etiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Electrocardiography</subject><subject>Esophagitis - complications</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastroesophageal reflux</subject><subject>Gastroesophageal Reflux - complications</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. 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Jared, MD</creator><creator>Packer, Douglas L., MD</creator><creator>Jahangir, Arshad, MD</creator><creator>Locke, G. Richard, MD</creator><creator>Talley, Nicholas J., MD, PhD</creator><creator>Gersh, Bernard J., MBChB, DPhil</creator><creator>Roy, Ranjini R., MD</creator><creator>Hodge, David O., MS</creator><creator>Asirvatham, Samuel J., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20081101</creationdate><title>Long-Term Risk of Atrial Fibrillation With Symptomatic Gastroesophageal Reflux Disease and Esophagitis</title><author>Bunch, T. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular system</topic><topic>Electrocardiography</topic><topic>Esophagitis - complications</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastroesophageal reflux</topic><topic>Gastroesophageal Reflux - complications</topic><topic>Health risk assessment</topic><topic>Heart</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Risk Factors</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bunch, T. Jared, MD</creatorcontrib><creatorcontrib>Packer, Douglas L., MD</creatorcontrib><creatorcontrib>Jahangir, Arshad, MD</creatorcontrib><creatorcontrib>Locke, G. Richard, MD</creatorcontrib><creatorcontrib>Talley, Nicholas J., MD, PhD</creatorcontrib><creatorcontrib>Gersh, Bernard J., MBChB, DPhil</creatorcontrib><creatorcontrib>Roy, Ranjini R., MD</creatorcontrib><creatorcontrib>Hodge, David O., MS</creatorcontrib><creatorcontrib>Asirvatham, Samuel J., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bunch, T. Jared, MD</au><au>Packer, Douglas L., MD</au><au>Jahangir, Arshad, MD</au><au>Locke, G. Richard, MD</au><au>Talley, Nicholas J., MD, PhD</au><au>Gersh, Bernard J., MBChB, DPhil</au><au>Roy, Ranjini R., MD</au><au>Hodge, David O., MS</au><au>Asirvatham, Samuel J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Risk of Atrial Fibrillation With Symptomatic Gastroesophageal Reflux Disease and Esophagitis</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2008-11-01</date><risdate>2008</risdate><volume>102</volume><issue>9</issue><spage>1207</spage><epage>1211</epage><pages>1207-1211</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The mechanisms underlying the triggers and maintenance of atrial fibrillation (AF) are not fully understood. One potential unproved mechanism is that gastroesophageal reflux disease (GERD), in which acid reflux induces local and systemic inflammation, may increase triggered activity in the myocardium and pulmonary veins and increase AF risk. A self-report questionnaire was mailed to a random sample of 5,288 residents of Olmsted County, Minnesota, aged 25 to 74 years to assess the presence and frequency of GERD from 1988 to 1994. The long-term risk for AF over a period of 11.4 ± 5.0 years was determined through review of clinical evaluations and the electrocardiographic database in those without previous AF. The average age was 53 ± 17 years, and 2,571 subjects (49%) were man. Of these patients, 741 developed AF (cumulative probability of AF at 18 years 20%, 95% confidence interval [CI] 17% to 22%). Age (hazard ratio [HR] 1.09, 95% CI 1.08 to 1.10, p <0.001), male gender (HR 1.81, 95% CI 1.53 to 2.14, p <0.001), hypertension (HR 1.36, 95% CI 1.14 to 1.61, p = 0.0006), and heart failure (HR 1.74, 95% CI 1.16 to 2.60, p = 0.007) were independently associated with the risk of AF. The presence of any GERD was not associated with risk for AF (HR 0.81, 95% CI 0.68 to 0.96, p = 0.014) after adjustment for other risk factors. The frequency of GERD did not significantly affect the risk for AF, although patients with more frequent GERD had a slightly higher AF risk. Esophagitis increased the risk for AF (HR 1.94, 95% CI 1.35 to 2.78, p <0.001), but the association did not persist when accounting for other risk factors (p = 0.72). In conclusion, in this large population-based study of patients surveyed for GERD, no association was found with the presence or frequency of symptoms and AF. Patients with esophagitis were more likely to develop AF, although this association requires further study.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18940293</pmid><doi>10.1016/j.amjcard.2008.06.048</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Atrial Fibrillation - diagnosis Atrial Fibrillation - etiology Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular system Electrocardiography Esophagitis - complications Esophagus Female Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Gastroesophageal reflux Gastroesophageal Reflux - complications Health risk assessment Heart Humans Hydrogen-Ion Concentration Male Medical sciences Middle Aged Other diseases. Semiology Risk Factors Surveys and Questionnaires Time Factors |
| title | Long-Term Risk of Atrial Fibrillation With Symptomatic Gastroesophageal Reflux Disease and Esophagitis |
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