Is There a Link Between Gastroesophageal Reflux Disease and Atrial Fibrillation?
Open accessAbstract
Background: Previous studies suggest a potential association between gastroesophageal reflux disease (GERD) and atrial fibrillation. Objective: To explore the potential association between GERD and atrial fibrillation. Materials and Methods: This was a retrospective study created from a database containing all health care encounters for patients who received ambulatory care in the National Capitol Area military health care system between January 1, 2001 and October 28, 2007. The study population included all subjects at least 18 years of age (n = 163 627). Our primary outcomes of interest were International Classification of Diseases, Ninth Revision (ICD‐9) diagnoses of atrial fibrillation and GERD. Results: Among 163 627 patients, 7992 (5%) had atrial fibrillation and 47 845 (29%) had GERD. The presence of GERD increased the relative risk (RR) of a diagnosis of atrial fibrillation (RR: 1.39, 95% confidence interval [CI]: 1.33–1.45). In sensitivity analyses, this relationship persisted after adjustment for cardiovascular disease risk factors (RR: 1.19, 95% CI: 1.13–1.25) and diagnoses known to be strongly associated with atrial fibrillation (RR: 1.08, 95% CI: 1.02–1.13). Conclusions: The presence of GERD is associated with an increased risk of a diagnosis of atrial fibrillation. Copyright © 2009 Wiley Periodicals, Inc.
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The direct correlation between exercise and a decrease in intra-esophageal pH, as well as acid reflux disease and an increased risk of AF, has been shown in many observational studies in elite athletes.
“The direct correlation between exercise and a decrease in intra-esophageal pH, as well as acid reflux disease and an increased risk of AF, has been shown in many observational studies in elite athletes [61,62,63,64].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [64]
The Discussion reports that GERD was associated with a 40% higher risk of atrial fibrillation, and Clinical Investigations continued describes a small study linking decreased intra-esophageal pH to AF onset. Neither passage links exercise to decreased pH or identifies elite athletes as the studied population, so those parts of the attributed claim are unsupported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAmong 163,627 patients, acid reflux disease significantly increased the risk of AF by 39%.
“Among 163,627 patients, acid reflux disease was shown to significantly increase the risk of AF by 39% [64].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [64]
The Results report 163,627 subjects and an unadjusted association between GERD and atrial fibrillation of RR 1.39 (95% CI 1.33–1.45), supporting the 39% figure. But the paper says its cross-sectional data are at best correlative, not evidence that GERD causes an increased risk; the association also weakens after adjustment. (LLM, conf=0.89)
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- J.S. Kunz et al: Is there a link between GERD and atrial fibrillation? Published online in Wiley InterScience. (www.interscience.wiley.com) DOI:10.1002/clc.20660 2009 Wiley Periodicals, Inc. · DOI
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- Authors
- Kunz, J. S., Hemann, B., Edwin Atwood, J., Jackson, J., Wu, T., & Hamm, C.
- Affiliations
- Walter Reed National Military Medical Center (US)
- Uniformed Services University of the Health Sciences (US)
- Corresponding author
- Kunz, Jeffrey S.
- ORCID
- Jackson, Jeffrey
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 2009-10
- Volume
- 32
- Issue
- 10
- Pages
- 584-587
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- PMC
- PMC6653088
- OpenAlex
- W2117560714
- Cited by
- 60
- References
- 52
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 9 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 2 · 2017: 2 · 2016: 6 · 2015: 8 · 2014: 1 · 2013: 6 · 2012: 3
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Cardiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- gastroesophageal reflux disease, atrial fibrillation, disease association, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Female, Gastroesophageal Reflux, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Logistic Models, Risk Assessment, Young Adult
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