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Does physiologic gastroesophageal reflux affect heart rate or rhythm?
R A Wright1, S A McClave, J Petruska
1Dept. of Medicine, University of Louisville, KY 40292.
Scandinavian Journal of Gastroenterology
|November 1, 1993
Summary
Physiologic gastroesophageal reflux does not affect heart rate or rhythm in humans. Studies found no link between reflux episodes and cardiac events like premature beats or abnormal heart rates.
Area of Science:
- Gastroenterology
- Cardiology
- Physiology
Background:
- A cholinergic esophagocardiac reflex, causing heart rate changes, is known in humans following acid infusion.
- This study investigates if this reflex occurs during normal gastroesophageal reflux and precipitates cardiac dysrhythmias.
Purpose of the Study:
- To determine if physiologic gastroesophageal reflux (GER) triggers cardiac arrhythmias.
- To investigate the relationship between esophageal acidification and heart rate variations.
Main Methods:
- Prospective study involving 20 patients undergoing 24-hour ambulatory esophageal pH monitoring and simultaneous cardiac Holter monitoring.
- Analysis focused on GER episodes causing esophageal pH < 4 for at least 60 seconds, examining heart rate variables before and after acidification.
Main Results:
- No significant relationship was found between physiologic GER episodes and premature ventricular contractions (PVCs), premature atrial contractions (PACs), tachycardia, or bradycardia.
- No statistically significant correlations were observed between total 24-hour acid exposure and mean heart rate, or the number of PVCs and PACs.
- Even prolonged reflux episodes (pH < 2 for > 5 min) did not alter pulse rate.
Conclusions:
- Physiologic gastroesophageal reflux does not induce changes in heart rate or rhythm in humans.
- Observed esophagocardiac reflexes during direct acid infusion may be due to factors other than physiologic reflux, such as lower pH, osmolarity, temperature, or specific receptor stimulation.