The Link Between Atrial Fibrillation and Gastroesophageal Reflux Disease - Pathophysiology, Emerging Evidence and Treatment Options

Gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) are common conditions that significantly impact gastrointestinal and cardiovascular health. Emerging evidence suggests a bidirectional relationship between these conditions, mainly driven by inflammation and vagal nerve stimulation. Shared risk factors include obesity, obstructive sleep apnea, and hiatal hernias. This review explores the underlying pathophysiological mechanisms that may link GERD and AF, focusing on the roles of autonomic dysregulation, systemic inflammation, and mechanical interactions that may cause symptoms for both diseases. Lifestyle modifications including weight management, along with pharmacological treatments like proton pump inhibitors, have shown promise in managing the symptoms of both conditions which otherwise may exacerbate one another. Despite the treatment progress, the causative link between GERD and AF is still uncertain, with various sources stating inconclusive evidence, necessitating further research. Future research should focus on therapeutic strategies for more optimized patient care, molecular pathways, and integrated care models addressing both gastrointestinal and cardiovascular health. Understanding the association between GERD and AF can help adjust clinical management and improve patient outcomes.