Reflux = arrhythmia

  I have recently posted messages that related to the topic of atrial arrhythmias
  caused by swallowing.  This connection appears to escape diagnosis and no one
  seems to acknowledge the potential for such a connection.  I have had this problem for
  several years and recently suffered atrial fibrillation that needed hospital intervention.
  Considering the fact that I am only 37 and in otherwise perfect health none of this has
  ever made much sense to me (famous last words I'm sure).  However my peculiar symptoms have
  kept me searching for some plausible answer.  Well due to the swallowing connection which happens
  every time (or at least it used to) I asked for a barium swallow to see if perhaps my esophagus
  had tied a reef knot around my heart.  Well it obviously had not but what did show up was the worst
  case of reflux my doctor had ever seen.  It seems in retrospect that a lot of the chest pain/discomfort
  that I attributed to the heart was in fact caused by the reflux (a common finding).  However the
  arrythmia is not so common.  My doctor put me on some artillery reflux meds called Pantaloc and Prepulsid
  and within 5 weeks the arrythmia stopped all together.  This is not a coincidence.  I was having approximately
  400-500 atrial ectopics per day, most precipitated by the action of swallowing.  The reflux was observed
  as high as the hypopharyx.  So what does this say about the possiblility that other lone fibbers could
  have the same mechanism?  I would never have suspected the reflux as most of the common symptoms were not
  present in my case.  I sleep great, no heatburn etc.  My only idea is that chronic irritation of the vagus
  nerve may have disrupted the delicate chemical balance and this may have influnced the rhythm of the heart.
  I would be very interested in your thoughts regarding this matter.  Thankyou.
Dear Peter:
You have made an extremely interesting observation.  As I mentioned in my response to your initial letter, I have seen a few cases like yours through the years.  In most of those situations, rapidly swallowing something hot or cold served as the trigger.  I suppose acid reflux could cause a similar sort of irritation to the esophagus and the local nerves that also affect heart function.  In fact, a good deal of research is ongoing to determine the possible links between acid reflux and coronary artery blood flow.  Certainly anyone with symptoms of acid reflux should be treated for that condition, regardless of the presence or absence of atrial fibrillation.  Whether patients with atrial fibrillation with no obvious cause (called "lone atrial fibrillation") should be tested for acid reflux (even if they do not have symptoms of reflux) is an interesting question, and one that is worth studying.  I will certainly keep the possiblility in mind in the future and I will mention it to the director of our large atrial fibrillation clinic.  Maybe you have come across an idea that will help several patients that are in your situation.  Furthermore, I am glad things worked out well for you.  Thanks for sharing your insights.

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