Running, esophageal acid reflux, and atrial fibrillation: A chain of events linked by evidence from separate medical literatures

Swanson, Don R.

doi:10.1016/j.mehy.2008.02.017

Cited by 27Atrial Fibrillation Management and OutcomesGastroesophageal reflux and treatmentsCardiovascular Effects of Exercise

Running, esophageal acid reflux, and atrial fibrillation: A chain of events linked by evidence from separate medical literatures

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Swanson, Don R.·2008·Medical Hypotheses

DOI 10.1016/j.mehy.2008.02.017PMC PMC3690799

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Abstract

Using a previously described approach to generating novel medical hypotheses, this paper shows how two separate medical literatures taken together can suggest new information not apparent in either literature alone. Many studies have demonstrated that aerobic exercise in healthy people can induce esophageal acidic reflux that increases with the duration and intensity of exercise. Separately, independently of exercise, it has been shown that, in patients with gastroesophageal reflux, esophageal acid exposure can lead to atrial fibrillation (AF) and to other heart dysrhythmias. The two arguments together suggest that a regimen of excessive exercise may be conducive to AF mediated by acid reflux, an implicit, but unpublished, hypothesis. Proton pump inhibitors are widely used to treat gastroesophageal reflux. Remarkably, several small clinical trials of these drugs have been shown also to reduce symptoms and frequency of AF episodes in patients with comorbid acid reflux. Plausible mechanisms have been suggested. These small-scale tests in a highly restricted population may be of particular interest in the light of a possible exercise-reflux-AF causal chain of events in a broader population of athletes. Because the minimum degree of esophageal acidity exposure required to induce AF is unknown, further tests of proton pump inhibitors for that purpose are therefore merited without regard to any known prior reflux in a population of runners with lone AF. The prospect of reducing AF…

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Physical activity could induce gastroesophageal reflux, and therefore lead to AF.
“Specifically, physical activity could induce gastroesophageal reflux, and therefore lead to AF [60].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [60]

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“Specifically, physical activity could induce gastroesophageal reflux, and therefore lead to AF [60].”
Background
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Authors: Swanson, D. R.
Affiliations: University of Chicago (US)
Corresponding author: Swanson, Don R.
Venue: Medical Hypotheses
Publisher: Elsevier BV
Published: 2008-08
Volume: 71
Issue: 2
Pages: 178-185
ISSN: 0306-9877 (ISSN-L)
DOI: 10.1016/j.mehy.2008.02.017
PMC: PMC3690799
OpenAlex: W2046006429
Cited by: 27
References: 33
Citations by year: 2024: 2 · 2022: 1 · 2020: 1 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 6 · 2013: 2 · 2012: 1
FWCI: 2.18
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Medical Hypotheses (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health
University of Illinois at Urbana-Champaign
National Institute of Mental Health
U.S. National Library of Medicine (R01LM007292)
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 › Cardiovascular Effects of Exercise
Keywords: atrial fibrillation, gastroesophageal reflux, esophageal acid exposure, aerobic exercise, runners, athletes, proton pump inhibitors, cardiac arrhythmias, lone atrial fibrillation, hypothesis generation
MeSH terms: Atrial Fibrillation, Electrocardiography, Esophagus, Gastroesophageal Reflux, Humans, Models, Biological, Models, Theoretical, Running, Exercise, Databases, Bibliographic, Proton Pump Inhibitors

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Running, esophageal acid reflux, and atrial fibrillation: A chain of events linked by evidence from separate medical literatures

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