Palpitations Associated With Frequent Premature Ventricular Contractions as an Important Manifestation of Gastroesophageal Reflux Disease.

BACKGROUND

There has been growing interest in the association between gastriesophageal reflux disease (GERD) and cardiac arrhythmias.

CASE SUMMARY: A 48-year-old man presented with palpitations predominantly occurring after alcohol intake or meals. Wearable electrocardiogram patch monitoring revealed that his frequent premature ventricular contractions (PVCs) were exclusively observed after alcohol intake or during postprandial periods. The PVCs could effectively be controlled with therapy for GERD. Another 40-year-old woman whose symptomatic PVCs were initially controlled with flecainide reported that her palpitations were aggravated when lying down. Flecainide was switched to a potassium-competitive acid blocker (PCAB), and the PVCs were better controlled with PCAB than with flecainide (0.01% vs 2.8% on flecainide).

DISCUSSION: PVCs may be triggered by GERD, and they can be effectively controlled by the appropriate treatment of the underlying GERD.

TAKE-HOME MESSAGE: When performing continuous electrocardiographic monitoring for frequent PVCs, it is important not only to assess their frequency but also to carefully analyze the timing of their occurrence.