Avaliaçãoobjetiva da doença do refluxo gastroesofágico em portadores de fibrilação atrial paroxística

• Autor(a) principal: Coutinho, Enia Lucia [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7003269; https://repositorio.unifesp.br/handle/11600/52121
• topic: Gastroesophageal reflux; Paroxistic atrial fibrillation; Esophageal PH monitoring; Gastroesophageal reflux disease; Refluxo gastroesofágico; Fibrilação atrial paroxística; Monitorização do PH esofágico; Doença do refluxo gastroesofágico

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Some evidence shows that gastroesophageal reflux disease (GERD) may be a trigger for paroxysmal AF (PAF). Most of the previous studies that correlated GERD and AF used questionnaires to diagnose GERD, not an objective evaluation. This study aims to evaluate in patients with PAF: (a) accuracy of symptoms to diagnose GERD; (b) prevalence of GERD; and (c) temporal correlation between cardiac arrhythmia and reflux. Methods: Twentytwo patients (59% females, mean age 68 years) with PAF underwent esophageal manometry followed by ambulatory pH monitoring and concurrent Holter. Eight (36%) patients had GERD symptoms. Patients were grouped as GERD+ or GERDbased on the DeMeester score. Temporal correlation between arrhythmia and reflux was recorded. Results: Six (27%) patients were GERD+. Symptoms had sensitivity and specificity of 50 and 70%, respectively, for the diagnosis of GERD. Episodic AF occurred in one patient only (GERD). There were 23 episodes of AF during the test with 14% correlation with reflux. Persistent AF during the period of the test was found in five patients (60% GERD?). Conclusions: Our results show: (a) Symptoms have a low accuracy for the diagnosis of GERD; (b) the prevalence of GERD in patients with PAF is low; and (c) temporal correlation between episodes of reflux and cardiac arrhythmia is low. Key Words: Gastroesophageal reflux – paroxistic atrial fibrillation – esophageal pH monitoring – gastroesophageal reflux disease.