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Small hiatal hernia as a risk factor of atrial fibrillation

Jan Głowacki1,2, Szymon Florek3, Alexander Suchodolski3

  • 1Department of Radiology and Radiodiagnostics, Silesian Medical University, Zabrze, Poland.

Polish Journal of Radiology
|March 12, 2021
PubMed

Insights

Small hiatal hernias (HH) may increase the risk of atrial fibrillation (AF). This study found a correlation between small HH and AF, but not larger hernias, suggesting HH as a potential AF risk factor.

Area of Science:

  • Cardiology
  • Radiology
  • Gastroenterology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia.
  • Hiatal hernia (HH) is a potential, yet under-investigated, risk factor for AF.
  • Understanding HH's role in AF is crucial for risk stratification.

Purpose of the Study:

  • To assess the prevalence of hiatal hernia (HH) in patients undergoing computed tomography (CT) for atrial fibrillation (AF) ablation.
  • To investigate the correlation between the presence and size of HH and AF.
  • To compare HH findings in AF patients versus a control group without AF.

Main Methods:

  • A cohort of 441 patients was analyzed.
  • Two groups were formed: 207 patients with AF undergoing pre-ablation CT, and 234 controls with no AF history undergoing CT for coronary disease assessment.
  • Hiatal hernias were evaluated on CT images.

Main Results:

  • Small hiatal hernias (≤ 2 cm) were significantly associated with a higher risk of AF compared to controls.
  • No significant association was found between larger hiatal hernias and AF.
  • The findings suggest a size-dependent relationship between HH and AF risk.

Conclusions:

  • The presence of small hiatal hernias (≤ 2 cm) may represent a significant risk factor for developing atrial fibrillation.
  • Further research is warranted to elucidate the pathophysiological mechanisms linking small HH to AF.
  • Identifying small HH could aid in identifying individuals at increased risk for AF.
Abstract

Keywords:
atrial fibrillationcomputed tomographyhiatal hernia

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