Vagus Nerve/LINX/PVC's

Hi all,

I have suffered from GERD for about 5 years now, but really badly for about 1.5 years. I know I have reflux because the DeMeester scores are always 20+, even on PPi's. I, however, have Eosinophilic Esophagitis without allergies, so GERD is probably the cause of that as well. I have had benign PVC's of the heart for about 12 years, and I swear that they are tied to pressure between heart and stomach/esophagus, and the pressure on the vagal nerves. I have seen that with the LINX, they dissect the vagal nerve on one side, placing the LINX underneath it, and laying the LINX on top of the vagus nerve on the other side of the esophagus. I have to wonder, would that create potential arrhythmia's via an irritated vagus nerve? Has anyone discussed this matter with a surgeon? Do any of you have any thoughts or ideas on this?

Thanks!

Hi hitThePost,

I didn't see any reports of vagus nerve related side effects in the Linx clinical study, so I think the odds of that are pretty low. The Roman Arch design of the Linx prevents it from putting significant pressue on the vagus nerve.

From anecdotal stories of vagus nerve damage in that area from fundoplication, the usual problem it seems to cause is dumping symdrome, so I'd be more worried about that happening than having side effects on the heart. I think the heart portion of the vagus nerve probably branches off above the location for the Linx, so I think the interaction from damage at the Linx location would be minimal. One doctor that worked on the clinical study was more concerned about damage to the vagus nerve if the Linx needed to be removed than during the implantation process. If you watch the video of the case where a Linx was removed, you can see that it was fully encased in tissue and had to be carefully wiggled and cut to get it out.

Every surgical procedure is gong to carry risks, but so far the Linx procedure appears to have few complications. Only time will tell if there are long term complications.

Hi Gazbiker,

The video of a linx being removed is here at about the 12 minute mark:

toraxmedicalspringlectures.com/lecture_noch.php?lecture_id=147&check1=555d6702c950ecb729a966504af0a635