Mechanisms underlying the sets off and maintenance of atrial fibrillation(AF) aren’t

Mechanisms underlying the sets off and maintenance of atrial fibrillation(AF) aren’t fully understood. 20%(95% CI 17-22%) at 18 years]. Age group[HR 1.09(95% CI 1.08-1.10) p<0.001] male gender[HR 1.81(95% CI 1.53-2.14) p<0.001] hypertension[HR 1.36(95% CI 1.14-1.61) p=0.0006) and center failure[HR 1.74(95% CI 1.16-2.60) p=0.007) were independently from the threat of AF. The current presence of any GERD was not associated with risk of AF[HR 0.81(95% CI 0.68-0.96) p=0.014] after adjustment for additional risk factors. Rate of recurrence of GERD did not significantly effect risk of AF although individuals with more frequent GERD experienced a slightly higher AF risk. Esophagitis improved risk of AF [HR = 1.94(95% CI 1.35-2.78) p<0.001] but the association did not persist when accounting for additional risk factors(p=0.72). In conclusion in this large population-based study of individuals surveyed for GERD we did not find an association with presence or rate of recurrence of symptoms and AF. Individuals with esophagitis were more likely to develop AF although this association requires TGX-221 further study. Intro New risk factors or risk “markers” for AF continue to be reported. Broadly these risk factors include systemic swelling1 obesity and sleep apnea2 alcohol3 4 and specific TGX-221 genetic mutations5-7. Environmental factors also play a key part in certain situations. In one study of individuals who developed lone AF the environment triggers were variable but unique and included: sleeping (44%) exercise (36%) alcohol use (36%) and eating (34%).8 Even though part of sleeping2 and alcohol intake3 4 have been previously established less is known about mechanisms underlying the association of AF and the gastrointestinal tract. One potential explanation is definitely that gastroesophageal reflux disease (GERD) underlies the association TGX-221 of eating and AF. A study of 3 individuals showed that AF onset was associated with a pH drop during 24 hour intraesophageal pH monitoring.9 It is reasonable to surmise that this association exists due to the proximity of the esophagus remaining atrium and pulmonary veins. Focal inflammation of the esophagus may inflame the myocardial and pulmonary vein cells and increase the risk of induced atrial activity. Also it is definitely conceivable that systemic effects from cytokine launch and impaired esophageal contractility associated with GERD could potentially increase the risk of AF.10 Therefore to analyze this potential association we undertook a large population-based study that surveyed the presence and frequency of GERD Rabbit polyclonal to ANGPTL6. and long-term risk of AF. Methods Olmsted County has a human population of nearly 120 0 people based upon the United States census in 2005. Nearly 80% of the population resides within 5 kilometers of the city of Rochester. The health care is definitely predominantly provided by two organizations: Mayo Medical Center and the Olmsted Medical Center. Within these two health systems medical diagnoses and surgical procedures are indexed when made as outpatients emergency room visits nursing home care hospital admissions and death certificates.11 This database allows investigation of the impact of diseases on a population over time. Using this database a random sample of the population was obtained with ages from 25-74 years between 1988 and 1994. Patients were excluded from the estimation of the AF risk if they had a preexisting diagnosis TGX-221 of AF. This database was used to abstract the general patient demographics as contained in Table 1. The diagnoses were determined by the attending physician and not based upon strict criteria. Table 1 Baseline demographics of Olmsted County patients based upon presence of any gastroesophageal reflux disease symptoms In order to assess the frequency of heartburn in the community patients were sent a study questionnaire as previously reported.12 The gastroesophageal reflux questionnaire was designed as a self-report instrument. The following definitions were used to define GERD as previously reported12: 1) heartburn a burning pain or discomfort behind the breast bone in the chest; 2) acid regurgitation a bitter- or sourtasting fluid coming into the throat or mouth; 3) chest pain any pain or discomfort felt inside the chest but no including heartburn or any pain that is primarily in the abdomen; 4) dysphagia (trouble swallowing) a feeling that food sticks in the throat or chest; 5) globus a feeling as if there is a lump in the throat when not swallowing 6 dyspepsia an ache or pain occurring mainly in the upper abdomen and not including heartburn chest pain or pain with menstrual periods 7 hoarseness rough and harsh voice; 8).