1Cardiologist, Emam Reza General Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Resident of Emergency Medicine, Emam Reza General Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Introduction: Atrial arrhythmia is a common complication in patients with gastro esophageal reflux disease (GERD). The treatment of palpitation is relatively problematic in these patients, especially if there is not enough evidence of cardiovascular or systemic diseases. The esophagus is in close proximity to the left atrium posterior wall. Hypothetically, locally released cytokines from esophageal injuries could stimulate the left atrium and produce premature atrial contractions. In this study we aimed to evaluate the effects of pantoprazole on palpitation in patients with reflux palpitation. Materials and Methods: This study was conducted on patients presented with palpitation and symptom of GERD from January 2014 to June 2014 in the General Clinic of Imam Reza Hospital. In order to establish the precise effects of pantoprazole on the treatment of palpitation in GERD patients, pantoprazole was added to the beta-blockers during treatment, and the patients were followed-up for one month. Results: In total, 10 patients within the age range of 21-35 years with a history of palpitation were enrolled in this study. The mean age of the subjects was 25 years, and the study group consisted of 6 men and 4 women. After a one-month follow-up, a significant reduction was observed in the palpitation of these patients (P<0.001). Conclusion: According to the results of this study, addition of pantoprazole to the treatment of palpitation was effective in patients with a history of GERD. Therefore, pantoprazole could be used as an effective adjunctive treatment for palpitation.
Roman C, Bruley des Varannes S, Muresan L, Picos A, Dumitrascu DL. Atrial fibrillation in patients with gastroesophageal reflux disease: a comprehensive review. World J Gastroenterol. 2014; 20:9592-9.
Gerson LB, Friday K, Triadafilopoulos G. Potential relationship between gastroesophageal reflux disease and atrial arrhythmias. J Clin Gastroenterol. 2006;40:828-32.
Kunz JS, Hemann B, Edwin Atwood J, Jackson J, Wu T, Hamm C. Is there a link between gastroesophageal reflux disease and atrial fibrillation?. ClinCardiol. 2009;32:584-7.
Reddy YM, Singh D, Nagarajan D, Pillarisetti J, Biria M, Boolani H, et al. Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome-the heart to gut connection!. J Interv Card Electrophysiol. 2013; 37:259-65.
Huang CC, Chan WL, Luo JC, Chen YC, Chen TJ, Chung CM, et al. Gastroesophageal Reflux Disease and Atrial Fibrillation: A Nationwide Population-BasedStudy. PLoS One.2012; 7: e47575
Nakamura H, Nakaji G, Shimazu H, Yasuda S, Odashiro K, Maruyama T, et al. Case of paroxysmal atrial fibrillation improved after the administration of proton pump inhibitor for associated reflux esophagitis. Fukuoka Igaku Zasshi. 2007; 98: 270–276.
Stollberger C, Finsterer J. Treatment of esophagitis/vagitisinduced paroxysmal atrial fibrillation by proton-pump inhibitors. J Gastroenterol. 2003; 38:1109.
Weigl M, Gschwantler M, Gatterer E, Finsterer J, Stollberger C. Reflux esophagitis in the pathogenesis of paroxysmal atrial fibrillation: results of a pilot study. South Med J. 2003; 96: 1128–32.
Bunch TJ, Packer DL, Jahangir A, Locke GR, Talley NJ, Gersh BJ, et al. Long-term risk of atrial fibrillation with symptomatic gastroesophageal reflux disease and esophagitis. Am J Cardiol. 2008; 102:1207–11.
Floria M, Drug VL. Atrial fibrillation and gastroesophageal reflux disease: From the cardiologist perspective. World J Gastroenterol. 2015;21:3154-6.
Lioni L, Letsas KP, Efremidis M, Vlachos K, Karlis D, Asvestas D, et al. Gastroesophageal reflux disease is a predictor of atrial fibrillation recurrence following left atrial ablation. Int J Cardiol. 2015; 183:211-3.
Schauerte P, Scherlag BJ, Pitha J, Scherlag MA, Reynolds D, Lazzara R, et al. Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation. Circulation. 2000;102:2774–80.
Chen PS, Tan AY. Autonomic nerve activity and atrial fibrillation. Heart Rhythm. 2007;4(3 Suppl):61–4.