P3254 - Impact of Esophageal Achalasia and Outcomes in Patients Hospitalized With Atrial Fibrillation: An Analysis of the National Inpatient Sample 2016-2019

Anwar Uddin, MD¹, Peter Lymberopoulos, MD¹, Aboud Kaliounji, MD², Madia Ahad, BS³, Afgal Ahad, MD¹, Louis Costanzo, MD¹, Tamta Chkhikvadze, MD^1
1SUNY Downstate Medical Center, Brooklyn, NY; ²SUNY Downstate Health Sciences University, Brooklyn, NY; ³AUC, Brooklyn, NY

Introduction: There is little data about the influence of esophageal achalasia and atrial fibrillation (afib). In this analysis the aim was to find if there was any correlation between esophageal achalasia and atrial fibrillation.

Methods: All patients with Atrial fibrillation (Afib)-related hospitalizations identified from Healthcare Cost and Utilization Project’s (HCUP) National Inpatient Sample (NIS) during 2016-2019 were included in this study. Patients with both Afib and Esophageal Achalasia is classified as the case group in this study. The propensity scoring method was used to select the Afib patients without Esophageal Achalasia as the control group. This matching method is used to mitigate selection bias and to control patient and institutional imbalances. The scoring was based on a multivariate logistic regression model.

Results: The baseline characteristics of Afib patients with and without Esophageal Achalasia were presented in Table 1. The analysis involved 220 patients in each group, resulting in a weighted sample size of 1,110. Patients with both conditions had a mean age of 76.83 years, 52.7% were female, the majority were White (87.7%), admitted to Urban teaching hospitals (70.9%), and utilized Medicare (83.2%). Propensity scoring method ensured well-matched baseline characteristics and no significant differences were observed (Table 1), reducing confounding factors. Outcome comparisons were made using multivariate logistic regression and regression models (Table 2). Disposition to routine care was slightly less frequent in Esophageal Achalasia patients (57.7% vs. 60.0%), but not statistically significant. No acute stroke or TIA cases were reported in either group. Acute heart failure occurred less frequently in Esophageal Achalasia patients (0.5% vs. 2.3%), but the difference was not statistically significant. Hospital mortality was slightly higher in Esophageal Achalasia patients (0.9% vs. 0%), but statistical comparison was not feasible due to the small number of events (Table 2).

Discussion: Limited evidence exists on esophageal motility disorder and afib, yet some studies have shown a link between achalasia and cardiac arrhythmias. The close proximity of the esophagus to the left atrium suggests that a dilated esophagus may worsen cardiac arrhythmias like Afib. Further research is needed to understand the relationship between Afib and esophageal achalasia.


Disclosures:


Anwar Uddin, MD¹, Peter Lymberopoulos, MD¹, Aboud Kaliounji, MD², Madia Ahad, BS³, Afgal Ahad, MD¹, Louis Costanzo, MD¹, Tamta Chkhikvadze, MD¹. P3254 - Impact of Esophageal Achalasia and Outcomes in Patients Hospitalized With Atrial Fibrillation: An Analysis of the National Inpatient Sample 2016-2019, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.