gerd and af interesting article

[Andyt36]

Gerd and af

academic.oup.com/europace/a...

[CDreamer]

Thanks for posting - I think it will resonate with many AF sufferers. I have all of the conditions mentioned and have been certain they are all linked for many years - this article is the ‘how’ as far as I am concerned.

Best wishes CD.

PS - I am not obese but I am overweight.

[pottypete1]

This article describes my condition perfectly.

I am seeing my EP next Wednesday and my Gastroenterologist the following week and this situation will be forming the basis of the discussions.

Pete

[CDreamer in reply to pottypete1]

So many of us have this experience and it is so helpful when everything can be linked. Please let us know your outcomes.

[pottypete1 in reply to CDreamer]

Yes I agree CD. By the way I am not obese either and only about a stone heavier than I would like to which was exacerbated by my inability to exercise due to my hernia.

Pete

[heartmatters1]

Yes, very interesting article Andy. I am almost sure my episodes are linked to indigestion/reflux. I have suffered with heartburn & ‘funny’ heart flutters since my first pregnancy over 40 years ago. Which has morphed into PAF. Thanks for sharing.

[Hidden]

Thanks Andy......very interesting!

[meadfoot]

Mirrors my current and long term experience perfectly. I am currently having cardiac and gastro symptoms investigated. I am certain that in my case there is an absolute link. My af originally started nearly ten years ago at exactly the same time I was undergoing investigations for gerd. My only issue with the article is the potential use of ppis, they are the devils drug for me, just tried them again and within days my heart was faffing around badly again.

[pottypete1]

Yes I agree about the PPIs. In an effort to beat my nausea my GP, EP and Gastroenterologist have taken me off Lanzoprozole and put me on to Raditine to see if it helps.

The plan is to first try Raditine, then to swap Warfarin for a NOAC anticoagulant as apparently Warfarin can cause my problem. Next reduce my Flecainide. The Flecanide dose is a bit of a gamble as on the whole my AF has been more stable since the ablation I had last year.

I do think they are experimenting but that is not surprising seeing that all the Meds we take for our ailments have side effects. In many cases the side effects being the very thing that they are trying to treat.

It is so difficult for me as I have been taking some of these things for decades. My hope is that if things are changed then a closer management of my condition can be set up. The way the health service works is like an oil tanker that takes 5 miles to stop. Whilst I have had GERD for many years my problems of nausea started a year ago and I am still searching for a solution.

In my case I believe my problems are related to my Vagal Nerve coupled with the proximity of the oesophagus to the back of my heart near the left atrium. I am convinced there must be a link. I have had PAF for so many years, 7 ablations and untold TOE scans all of which were taking place within such a very localised area of my anatomy. I cannot believe that years of these problems coupled with all the Meds have not taken a toll on my condition.

I hope that my consulations next week and the week after bring progress. But I think maybe the grim reaper with get me before the eureka moment takes place.

Pete

[Andyt36]

Question is and you all may have more experience than I is how to we get an integrated approach? Thoughts

[pottypete1]

That is the $64,000 dollar question.

Among many things I have learned from this forum are:

1 We are all different.

2.The vast majority of specialist doctors have a different approach to treating AF.

3. There is absolutely no standard practice regarding the Meds that are prescribed.

Common sense tells me that Meds must have side effects that we are unaware of and that the physical condition and age must be a contributory factor.

Pete

[Buffafly in reply to pottypete1]

A couple of recent posts have set me thinking about interactions too, am going to post my thoughts separately.

[Angie06]

I'm also very interested in this research as I've been on meds for AF (10yrs) and PPI's for Gerd (8yrs) after experimenting with different drugs for Gerd have settled on Omeprazole and take Flecainide for AF . I haven't had an episode of AF since diagnosis and as long as I stay off the triggers for Gerd, noticeably fatty foods and alcohol, my stomach seems fairly happy. So although both these drugs are potent I'd rather take them and feel ok than go without. I've also had a Left atrial appendage device fitted so no need for me to take anticoagulants. Fingers crossed I only have to take 2 tablets a day for a few years more! 😀

[seasider18]

They make it sound like a new discovery. Those of us with the condition have been seeing doctors shaking their heads when we have suggested the connection over many years.

[Chris1945 in reply to seasider18]

Yes, I totally agree, since the get-go when I was first diagnosed with PAF, I've always instinctively known that it is related to digestive/vagus nerve issues but was met with condescending smiles and shaking of the head from cardiologists and my GP. However, an EP I saw, did concede that 'in 5% of AF patients it was caused by 'tonal issues' but until I know for sure that I'm one of them, I refused ablation. Sanjay Gupta has a video on the subject on youtube which is worth a watch. I'm not sure though which specialist deals with the vagus nerve issue, is it a cardiologist or a gastroenterologist, does anyone know please? One thing I do know, since changing my diet and eating less and not eating after 6 at the latest, not only have I lost weight, but it seems to help keep the beast at bay.

[seasider18 in reply to Chris1945]

As well as digestive issues both a colonoscopy and a DRE have stimulated my vagus nerve and put me back into AF more than a year after successful cardioversions.

[Chris1945 in reply to seasider18]

Oh dear, so maybe not a good idea to have the procedure done! On the plus side, I guess it supports our view that there is a definite connection....?

[seasider18 in reply to Chris1945]

They are doing the colonoscopy and I am slightly sedated but feel ok watching it on the screen. On the other screen I see my BP dropping to 40/29 and heart rate 30. I think are they going to do something about this? They suddenly panic.

Discharge notes say:

“Gellofusion was administered and .1ml of atropine given. Anaesthetist was called who then administered 1L of Hartman’s solution, an extra 3 mls of atropine and 20 mg of Boscopon .

Patient much improved and monitored in his room for rest of day” In an NHS hospital I would be on a trolley in the corridor.

Heart rate went up in the room and by mid-afternoon after being on a drip and having tea and toast and lots of water my BP was 123/67 which made them happy

Later when walking up a slight slope I feel my heart racing and stop for a few moments and realised that I was back in AF.

There is a virtual colonoscopy with an MRI that you can have but then if there is anything suspicious they cannot take a sample. I had suggested that to my doctor but he persuaded me otherwise.

[Auriculaire in reply to seasider18]

Interesting. I have had 3 attacks of afib this year. The first a few days after having a colectomy to remove 26 cm of my colon. I was very dehydrated as they had removed the drip and catheter that morning. My bladder was irritated causing me to pee lots but I could not put the fluid back in as anything other than small sips aggravated the bloating from the gases they pump in for the keyhole surgery. I was also starving having had nothing to eat other than yoghurt and apple compote for 3 days. I went back into sinus the next morning after eating the first solid breakfast ( and taking some magnesium). The second was a week after my post op colonoscopy. The third was a week after finishing taking oil of oregano ( a natural antibiotic but still it affects the microbiome) for a UTI. All of these related to an upset gut. The problem with western medicine is that it splits the body up into it's various bits and does not see it as an inextricably connected whole. PPIs might give some relief for Afib but I believe this will be temporary as they prevent magnesium and B12 absorption. Magnesium deficiency is not good for the heart and indeed long term ingestion of PPIs have been shown to cause heart problems.

[DK81]

As reported previously, the performance of my digestive system has been much better since I started taking a low dose of statins (20 mg Atorvastatin). My theory is that the statins have reduced the degree of inflammation in my body, with a consequential improvement in heart performance. (See "AFib better after stroke" posted two months ago.)

[Alancockerill]

Very interesting post. Thank you. So much seems to be misunderstood about AF and even te "experts" seem to have areas of complete disagreement.

I’ve had some GERD issues in the past and was on omeprazole daily. About eighteen months ago I had a review of my meds and my GERD seemed under control so it was suggested I just took it if I experienced symptoms. We were sensibly trying to reduce my meds (where we could). There have been some episodes but nowhere near as bad as before. What is interesting is that my AF symptoms returned (after three or four years with only very sporadic episodes - maybe once very four to eight weeks and then only light, short duration episodes) and became almost daily soon after I stopped taking omeprazole on a daily basis.

So now I wonder if my AF is linked to GERD? I might try taking the omeprazole daily for a month and see if my AF episodes decrease. I currently take Cardicor (beta blockers) 10mg daily and have some Flecianide 50mg to take if I feel any symptoms. I currently experience an AF episode about once a week, often very faint if I catch it early and take the Flecianide.

[dmjtanner]

This article really makes a lot of sense. One of my episodes started with drinking cold orange juice and I sometimes have increased palpitations after eating. The disturbing part towards the beginning of the article says “af doubles mortality” and I thought you couldn’t die from af.

[Gertsen]

Thank you for this.

Interesting.

[Breezera]

It is my first hand long-time experience that AF is very much linked to GERD and digestive issues. Through online research I discovered that where digestive functions are concerned the vagus nerve is intrinsically involved. When we eat the vagus nerve initiates/controls our stomach contractions that work to digest what we've consumed. And the vagus nerve - a key part of the parasympathetic nervous system - also plays an important role in regulating our heart rate. If the vagus nerve is inflamed or otherwise "acting up", it can have a detrimental effect on how our heart beats. With that in mind.. I have read that the pulmonary veins are heavily innervated. It is my belief that the state of the vagus nerve can affect the extent/strength of pulmonary vein influence in the triggering of arrhythmia (AF) in the left atrium.

Prior to my PVI cryo-ablation (21-Aug-2018) I was having an AF episode every 10-14 days, and the vast majority of those episodes were triggered by either vagal (digestive) or body positional influences. Since having my PVI ablation (about 11 weeks ago) I have thankfully had no AF whatsoever, and I've been slowly re-introducing foods and beverages that were previously known to be certain AF triggers for me. And for the first time in years I am now able to sleep on my left side without incident.

So far my PVI cryo-ablation has done wonders for me - I have my life back!

Best wishes to all.

- Richard

[faridaro]

This might explain why my AF episodes sometimes triggered by eating, bending or lying down. Even though I experience typical symptoms of GERD only occasionally and AF episodes almost daily even though being on Flecainide, however there could by silent GERD.

My husband who has been on various anti GERD medications for decades, lately has been getting relief from homeopathic remedy Nat Phos although initially he was very skeptical about it - I am going to give it a try as well.

[Gwersey]

Just read the article. Interestingly, it mentions something I've posted about in the past, that defacating can bring on an AF episode. And the article seems to more or less confirm the correlation between GERD, oesophogitis and AF, all three of which I suffer with. It only touches on ectopics though, which is my biggest bugbear.