Digestive Disorders / Gastroenterology Forum
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Avatar universal

GERD / atrial arrhythmias

  Hello again.  I wrote a few messages early this year with regards to
  this subject but more information has come to light.  Briefly my
  history has been 8 years of paroxsmyl atrial arrythmias with a few
  confirmed afib occurrences that needed meds to convert.  Despite my
  athletic/aerobic years this caught me off guard to say the least.
  Being male, 37 and in otherwise perfect health (non-smoker/drinker etc.)
  none of the cardiologists can explain this.  A few symptoms made me search
  for an alternative explanation other than the typical cardiac ones.  Chest pains,
  the feeling of fulness in the back of my throat and a feeling of
  "a rising plume from the stomach", especially when I run made me think
  of GERD.  The other peculiar symptom is the correlation with swallowing.
  Every time I swallow my heart beat pauses momentarily.  This has been
  documented on ECG many times. In fact, while wearing a holter monitor
  the swallowing action precipitated a run of afib with heart rates
  approaching 240 bpm,which lasted about 15 seconds. None of the cardiologists
  has ever heard of this correlation before.  In my case it is 100% reproducible and
  not a coincidence.  At my request I had a barium swallow which showed
  significant esophagitis (to everyone's surprise).  A gastroscopy confirmed this along with
  the presence of significant bile in the stomach.  I have been on
  Prepusid and Pantoprazole several times and this has alleviated the
  heart rhythm problem.  It always seems to come back if I eat poorly
  or assume my running routines.  Yesterday I tried extra strength
  Gaviscon for the first time (in the last month this has all returned
  again).  The symptoms were noticeably improved within a few hours,
  including the heart beat.  So what are my questions??
  1.  Have you come across any other cases where GERD has affected the
  heart rhythm?  Since I have embarked on this research I have been inundated
  by responses from people with similar stories.
  2.  Can you postulate a theory as to why it happens?  I firmly
  believe the Vagus nerve is somehow being inappropriated stimulated (triggered by swallowing action)
  due to the esophagitis.  The vagal effect on the heart is to slow it
  down, which is fine at night but not during a run or times of activity,
  when I have most of my troubles (I have always slept like a baby).
  3.  What does the presence of bile in the stomach suggest about
  this condition?  Could this indicate poor gastric motility and
  if so what else could be done about it?
  4.  I also have Gilbert's syndrome and a fatty liver.  Could this
  be a factor?
  Thank you for you time.
1 Responses
Avatar universal

Dear Peter,
Thank you for your most recent contribution to our Forum.  We have received many postings describing cardiav arrythmias related to reflux.  It is apparent that the problem is more commmon than physicians realize.  With regard to your specific questions
1) The vagus nerve regulates swallowing and heart rythm as well as transmits sensory information regarding the esophagus to the brain.  INflammation of vagal fibers (as can be seen with esophagitis) may alter the neural tone that controls heart rythm.  The specific mechanism would be highly speculative.
2)Bile in the stomach is a frequent finding during endoscopy.  Bile can reflux into the esophagus.  The role of bile in the genesis of the cardiac arrythmias is unknown.
3) Your liver problems are independent of the cardiac problem.
This information is presented for educational purposes.  ASk specific questions to your personal physician.
*keywords: esophageal reflux, cardiac arrthymia

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