- Question
- Does regular consumption of caffeinated coffee, compared with abstinence from coffee and caffeine, change the recurrence of atrial fibrillation (AF) or atrial flutter?
- Design
- Prospective, open-label, 1:1 randomized clinical trial of 200 patients enrolled at 5 hospitals in the US, Canada, and Australia between November 2021 and December 2024. Follow-up lasted 6 months.
- Population
- Adults who currently drank coffee or had done so within the past 5 years, with persistent AF or atrial flutter with a history of AF, and a planned electrical cardioversion. Mean age was 69 years and 71% were male.
- Intervention
- Regular caffeinated coffee consumption for 6 months, with encouragement to drink at least 1 cup daily. Intake during follow-up in this group was 7 cups per week (IQR, 6-11).
- Control
- Complete abstinence from caffeinated and decaffeinated coffee and other caffeine-containing products for 6 months. Intake during follow-up was 0 cups per week (IQR, 0-2).
- Primary outcome
- Clinically detected recurrence of AF or atrial flutter over the 6 months of follow-up.
- Results
- Recurrence was lower with coffee consumption (47%) than with abstinence (64%), with an HR of 0.61 (95% CI, 0.42-0.89; P = .01). A comparable benefit was seen when considering AF recurrence alone.
- Safety
- There were no significant differences in adverse events between the groups.
- Conclusion
- Among coffee drinkers after successful cardioversion, allocation to caffeinated coffee consumption (about 1 cup a day) was associated with less AF or atrial flutter recurrence than abstinence.
- Why it matters
- It challenges the conventional belief that caffeinated coffee is proarrhythmic and should be avoided by patients with AF, as the first randomized trial to address this question.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026