Objective:

To evaluate the relationship between coffee consumption and atrial fibrillation (AF) recurrence risk.

Approach:

• Evidence Review: The writing group summarized various studies including prospective cohort studies, systematic reviews, meta-analyses, Mendelian randomization analyses, and randomized clinical trials.

Key Findings:

• Moderate coffee consumption (up to 400 mg of caffeine daily) is generally safe for most adults.
• No higher risk of AF was found with moderate coffee consumption; some studies indicated a lower risk.
• Daily coffee consumption reduced the risk of recurrent AF by 39% in patients scheduled for elective cardioversion, according to the DECAF trial.
• Caffeinated coffee increased premature ventricular contractions (PVCs) but did not increase premature atrial contractions, as observed in the CRAVE trial.
• Observational studies showed that up to six cups of coffee daily were not associated with a higher risk of coronary artery disease.
• Habitual coffee consumption was linked to a lower incidence of type 2 diabetes.

Interpretation:

The findings suggest that moderate coffee consumption can be part of a healthy lifestyle for most adults, particularly those with AF.

Limitations:

• Most evidence is observational, which may be subject to residual confounding and healthy-user bias.
• Acute caffeine effects may differ from habitual consumption effects, and the long-term relationship with blood pressure remains uncertain.

Conclusion:

Moderate coffee consumption does not need to be avoided in patients with AF solely for recurrence risk reduction.

Sources:

• Circulation