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6793273 
Journal Article 
Gastroesophageal reflux disease and atrial fibrillation: Insight from autonomic cardiogastric neural interaction 
Huang, TC; Tsai, TY; Liu, PYen; Chen, SAnn; Lo, LiWei; Yamada, S; Chou, YuHui; Lin, WeiLun; Chang, SLin; Lin, YJ; Liu, SH; Cheng, WenHan; , 
2019 
Yes 
Journal of Cardiovascular Electrophysiology
ISSN: 1045-3873
EISSN: 1540-8167 
WILEY 
HOBOKEN 
2262-2270 
31515888 
WOS:000493029100011 
Background The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility. Methods Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment. Results Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P < .05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3. Conclusions In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF-making it highly likely that autonomic activity is important in mediating this effect.