Association between gastroesophageal reflux disease and atrial fibrillation: a systematic review and meta-analysis

Background and objective: associations between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) are inconclusive. Some studies found that AF was a risk factor for GERD whereas other studies showed opposite results.The primary objective of this study was to systematically evaluate whether GERD and AF have a bidirectional association using a meta-analysis. Methods: a systematic review was conducted of studies on the association between GERD and AF, written in the English language and included in Cochrane CENTRAL, PubMed and EMBASE until February 2017.The search was limited to longitudinal, case-control, and cross-sectional studies. Results: among 548 studies found in the above-mentioned databases, seven fulfilled the inclusion criteria. Among these seven studies, two were longitudinal studies, two were case-control studies, and three were cross-sectional studies. The summary adjusted relative risks (RRs) for AF-induced GERD and GERD-induced AF were 1.54(95% CI, 1.08-2.17) and 1.06 (95% CI, 0.86-1.31), respectively.The subgroup analysis showed that the associations were not significantly modified by sample size, study design, age, or geographic area. Conclusions: this meta-analysis supported the association of AF with increased risk of GERD.