Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients

Ranjini R. Roy, Sandeep Sagar, T. Jared Bunch, Wahaj Aman, Daniel J. Crusan, Komandoor Srivathsan, Samuel J Asirvatham, Win K. Shen, Arshad Jahangir

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Hiatal hernia (HH) causes protrusion of the stomach into the chest cavity, directly impinging on the left atrium and possibly increasing predisposition to atrial arrhythmogenesis. However, such association has not been fully explored. The objective was to determine if an association between HH and atrial fibrillation (AF) exists and whether there are age-and sex-related differences. Methods: Adult patients diagnosed with HH from 1976 to 2006 at Mayo Clinic Rochester, Minnesota, were evaluated for AF. The number of patients with AF and HH was compared to age-and sex-matched patients with AF reported in the general population. Long-term outcomes were compared to corresponding county and state populations. Results: During the 30-year period, 111,429 patients were diagnosed with HH (mean age 61.4 ± 13.8 years, 47.9% male) and 7,865 patients (7.1%) also had a diagnosis of AF (mean age 73.1 ± 10.5 years; 55% male). In younger patients (<55 years), the occurrence of AF was 17.5-fold higher in men with HH and 19-fold higher in women with HH compared to the frequency of AF reported in the general population. Incidence of heart failure for patients with AF and HH was worse compared to the overall county population, but better than for those with AF. Similarly, mortality was worse in patients with AF and HH compared to the overall state population, but better than for those with AF in the county. Conclusions: Hiatal hernia appears to be associated with increased frequency of AF in both men and women of all age groups, but particularly in young patients. Further studies are needed to investigate this possible association and underlying mechanism.

Original languageEnglish (US)
Pages (from-to)11-15
Number of pages5
JournalJournal of Atrial Fibrillation
Volume6
Issue number2
StatePublished - Aug 2013

Fingerprint

Hiatal Hernia
Atrial Fibrillation
Population
Heart Atria
Sex Characteristics
Stomach
Thorax
Heart Failure
Age Groups

Keywords

  • Atrial fibrillation
  • Congestive heart failure
  • Gastroesophageal reflux disease
  • Hiatal hernia
  • Mortality
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Roy, R. R., Sagar, S., Bunch, T. J., Aman, W., Crusan, D. J., Srivathsan, K., ... Jahangir, A. (2013). Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients. Journal of Atrial Fibrillation, 6(2), 11-15.

Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients. / Roy, Ranjini R.; Sagar, Sandeep; Bunch, T. Jared; Aman, Wahaj; Crusan, Daniel J.; Srivathsan, Komandoor; Asirvatham, Samuel J; Shen, Win K.; Jahangir, Arshad.

In: Journal of Atrial Fibrillation, Vol. 6, No. 2, 08.2013, p. 11-15.

Research output: Contribution to journalArticle

Roy, RR, Sagar, S, Bunch, TJ, Aman, W, Crusan, DJ, Srivathsan, K, Asirvatham, SJ, Shen, WK & Jahangir, A 2013, 'Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients', Journal of Atrial Fibrillation, vol. 6, no. 2, pp. 11-15.
Roy, Ranjini R. ; Sagar, Sandeep ; Bunch, T. Jared ; Aman, Wahaj ; Crusan, Daniel J. ; Srivathsan, Komandoor ; Asirvatham, Samuel J ; Shen, Win K. ; Jahangir, Arshad. / Hiatal Hernia is associated with an increased prevalence of atrial fibrillation in young patients. In: Journal of Atrial Fibrillation. 2013 ; Vol. 6, No. 2. pp. 11-15.
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abstract = "Purpose: Hiatal hernia (HH) causes protrusion of the stomach into the chest cavity, directly impinging on the left atrium and possibly increasing predisposition to atrial arrhythmogenesis. However, such association has not been fully explored. The objective was to determine if an association between HH and atrial fibrillation (AF) exists and whether there are age-and sex-related differences. Methods: Adult patients diagnosed with HH from 1976 to 2006 at Mayo Clinic Rochester, Minnesota, were evaluated for AF. The number of patients with AF and HH was compared to age-and sex-matched patients with AF reported in the general population. Long-term outcomes were compared to corresponding county and state populations. Results: During the 30-year period, 111,429 patients were diagnosed with HH (mean age 61.4 ± 13.8 years, 47.9{\%} male) and 7,865 patients (7.1{\%}) also had a diagnosis of AF (mean age 73.1 ± 10.5 years; 55{\%} male). In younger patients (<55 years), the occurrence of AF was 17.5-fold higher in men with HH and 19-fold higher in women with HH compared to the frequency of AF reported in the general population. Incidence of heart failure for patients with AF and HH was worse compared to the overall county population, but better than for those with AF. Similarly, mortality was worse in patients with AF and HH compared to the overall state population, but better than for those with AF in the county. Conclusions: Hiatal hernia appears to be associated with increased frequency of AF in both men and women of all age groups, but particularly in young patients. Further studies are needed to investigate this possible association and underlying mechanism.",
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AU - Roy, Ranjini R.

AU - Sagar, Sandeep

AU - Bunch, T. Jared

AU - Aman, Wahaj

AU - Crusan, Daniel J.

AU - Srivathsan, Komandoor

AU - Asirvatham, Samuel J

AU - Shen, Win K.

AU - Jahangir, Arshad

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N2 - Purpose: Hiatal hernia (HH) causes protrusion of the stomach into the chest cavity, directly impinging on the left atrium and possibly increasing predisposition to atrial arrhythmogenesis. However, such association has not been fully explored. The objective was to determine if an association between HH and atrial fibrillation (AF) exists and whether there are age-and sex-related differences. Methods: Adult patients diagnosed with HH from 1976 to 2006 at Mayo Clinic Rochester, Minnesota, were evaluated for AF. The number of patients with AF and HH was compared to age-and sex-matched patients with AF reported in the general population. Long-term outcomes were compared to corresponding county and state populations. Results: During the 30-year period, 111,429 patients were diagnosed with HH (mean age 61.4 ± 13.8 years, 47.9% male) and 7,865 patients (7.1%) also had a diagnosis of AF (mean age 73.1 ± 10.5 years; 55% male). In younger patients (<55 years), the occurrence of AF was 17.5-fold higher in men with HH and 19-fold higher in women with HH compared to the frequency of AF reported in the general population. Incidence of heart failure for patients with AF and HH was worse compared to the overall county population, but better than for those with AF. Similarly, mortality was worse in patients with AF and HH compared to the overall state population, but better than for those with AF in the county. Conclusions: Hiatal hernia appears to be associated with increased frequency of AF in both men and women of all age groups, but particularly in young patients. Further studies are needed to investigate this possible association and underlying mechanism.

AB - Purpose: Hiatal hernia (HH) causes protrusion of the stomach into the chest cavity, directly impinging on the left atrium and possibly increasing predisposition to atrial arrhythmogenesis. However, such association has not been fully explored. The objective was to determine if an association between HH and atrial fibrillation (AF) exists and whether there are age-and sex-related differences. Methods: Adult patients diagnosed with HH from 1976 to 2006 at Mayo Clinic Rochester, Minnesota, were evaluated for AF. The number of patients with AF and HH was compared to age-and sex-matched patients with AF reported in the general population. Long-term outcomes were compared to corresponding county and state populations. Results: During the 30-year period, 111,429 patients were diagnosed with HH (mean age 61.4 ± 13.8 years, 47.9% male) and 7,865 patients (7.1%) also had a diagnosis of AF (mean age 73.1 ± 10.5 years; 55% male). In younger patients (<55 years), the occurrence of AF was 17.5-fold higher in men with HH and 19-fold higher in women with HH compared to the frequency of AF reported in the general population. Incidence of heart failure for patients with AF and HH was worse compared to the overall county population, but better than for those with AF. Similarly, mortality was worse in patients with AF and HH compared to the overall state population, but better than for those with AF in the county. Conclusions: Hiatal hernia appears to be associated with increased frequency of AF in both men and women of all age groups, but particularly in young patients. Further studies are needed to investigate this possible association and underlying mechanism.

KW - Atrial fibrillation

KW - Congestive heart failure

KW - Gastroesophageal reflux disease

KW - Hiatal hernia

KW - Mortality

KW - Stroke

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