Letters To The Editor
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World J Gastroenterol. Mar 14, 2015; 21(10): 3154-3156
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.3154
Atrial fibrillation and gastroesophageal reflux disease: From the cardiologist perspective
Mariana Floria, Vasile Liviu Drug
Mariana Floria, Gr. T. Popa University of Medicine and Pharmacy, 700111 Iasi, Romania
Vasile Liviu Drug, Institute of Gastroenterology and Hepatology of Sf. Spiridon University Hospital, Gr. T. Popa University of Medicine and Pharmacy, 700111 Iasi, Romania
Author contributions: Both of the authors contributed equally to the manuscript, drafting the article and revising it critically for important intellectual content; both approved the final version for publication.
Supported by A grant from University of Medicine and Pharmacy Grigore T. Popa Iasi, Romania, No. POSDRU/159/1.5/S/133377.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Floria Mariana, MD, PhD, Gr. T. Popa University of Medicine and Pharmacy, 1 Independentei Street, 700111 Iasi, Romania. floria_mariana@yahoo.com
Telephone: +4-232-240822 Fax: +4-232-217781
Received: August 18, 2014
Peer-review started: August 20, 2014
First decision: October 29, 2014
Revised: November 16, 2014
Accepted: December 20, 2014
Article in press: December 22, 2014
Published online: March 14, 2015
Processing time: 209 Days and 19 Hours
Abstract

We have read with interest the paper by Roman C. and colleagues discussing the relationship between gastroesophageal reflux disease and atrial fibrillation. The review is presenting the available evidence for the common pathogenic mechanisms. However, from a cardiologist perspective, some available data were not highlighted in the review, cardiovascular involvement in gastroesophageal reflux is less assessed. Hypertension, obesity or diabetes mellitus are substrate for left atrial remodeling that initiate and sustained atrial fibrillation development. One of the pathophysiologic mechanisms in atrial fibrillation is the presence of a trigger. Gastroesophageal reflux could be only a trigger for this arrhythmia. We believe that atrial fibrillation should be considered as possible extraesophageal syndrome in the gastroesophageal reflux classification.

Keywords: Atrial fibrillation; Gastroesophageal reflux disease; Trigger; Substrate; Vagal stimulation

Core tip: The cardiologist point of view about the relationship between atrial fibrillation and gastroesophageal reflux disease is less expressed in the literature. However cardiovascular involvement in gastroesophageal reflux is less assessed. Hypertension, obesity or diabetes mellitus are substrate for left atrial remodeling that initiate and sustained atrial fibrillation development. One of the pathophysiologic mechanisms in atrial fibrillation is the presence of a trigger. Gastroesophageal reflux could be only a trigger for this arrhythmia. We believe that atrial fibrillation should be considered as possible extraesophageal syndrome in the gastroesophageal reflux classification.