Gastroesophageal reflux disease and atrial fibrillation: Insight from autonomic cardiogastric neural interaction

Ting Chun Huang, Li Wei Lo, Shinya Yamada, Yu Hui Chou, Wei Lun Lin, Shih Lin Chang, Yenn Jiang Lin, Shin Huei Liu, Wen Han Cheng, Tsung Ying Tsai, Ping Yen Liu, Shih Ann Chen

Research output: Contribution to journalArticle

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Abstract

Background: The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility. Methods: Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment. Results: Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P <.05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3. Conclusions: In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF—making it highly likely that autonomic activity is important in mediating this effect.

Original languageEnglish
Pages (from-to)2262-2270
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume30
Issue number11
DOIs
Publication statusPublished - 2019 Nov 1

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Gastroesophageal Reflux
Atrial Fibrillation
Electrophysiology
Acids
Muscarinic Antagonists
Autonomic Nervous System
Ventricular Fibrillation
Rabbits
Control Groups

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Huang, Ting Chun ; Lo, Li Wei ; Yamada, Shinya ; Chou, Yu Hui ; Lin, Wei Lun ; Chang, Shih Lin ; Lin, Yenn Jiang ; Liu, Shin Huei ; Cheng, Wen Han ; Tsai, Tsung Ying ; Liu, Ping Yen ; Chen, Shih Ann. / Gastroesophageal reflux disease and atrial fibrillation : Insight from autonomic cardiogastric neural interaction. In: Journal of Cardiovascular Electrophysiology. 2019 ; Vol. 30, No. 11. pp. 2262-2270.
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abstract = "Background: The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility. Methods: Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment. Results: Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P <.05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3. Conclusions: In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF—making it highly likely that autonomic activity is important in mediating this effect.",
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Huang, TC, Lo, LW, Yamada, S, Chou, YH, Lin, WL, Chang, SL, Lin, YJ, Liu, SH, Cheng, WH, Tsai, TY, Liu, PY & Chen, SA 2019, 'Gastroesophageal reflux disease and atrial fibrillation: Insight from autonomic cardiogastric neural interaction', Journal of Cardiovascular Electrophysiology, vol. 30, no. 11, pp. 2262-2270. https://doi.org/10.1111/jce.14181

Gastroesophageal reflux disease and atrial fibrillation : Insight from autonomic cardiogastric neural interaction. / Huang, Ting Chun; Lo, Li Wei; Yamada, Shinya; Chou, Yu Hui; Lin, Wei Lun; Chang, Shih Lin; Lin, Yenn Jiang; Liu, Shin Huei; Cheng, Wen Han; Tsai, Tsung Ying; Liu, Ping Yen; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 30, No. 11, 01.11.2019, p. 2262-2270.

Research output: Contribution to journalArticle

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T1 - Gastroesophageal reflux disease and atrial fibrillation

T2 - Insight from autonomic cardiogastric neural interaction

AU - Huang, Ting Chun

AU - Lo, Li Wei

AU - Yamada, Shinya

AU - Chou, Yu Hui

AU - Lin, Wei Lun

AU - Chang, Shih Lin

AU - Lin, Yenn Jiang

AU - Liu, Shin Huei

AU - Cheng, Wen Han

AU - Tsai, Tsung Ying

AU - Liu, Ping Yen

AU - Chen, Shih Ann

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Y1 - 2019/11/1

N2 - Background: The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility. Methods: Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment. Results: Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P <.05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3. Conclusions: In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF—making it highly likely that autonomic activity is important in mediating this effect.

AB - Background: The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility. Methods: Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment. Results: Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P <.05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3. Conclusions: In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF—making it highly likely that autonomic activity is important in mediating this effect.

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