Caffeine

I have read conflicting data on drinking caffeine and afib. Some have said it is a trigger and others say while it may exacerbate pac or pvc activity it is not an afib determinant. Anyone here have any advice or clear guidance. I must admit I do love my one cup of coffee or tea each day. Thanks in advance for your insights.
I had an afib ablation three years ago and have not had any sustained tachycardia since except in short bursts during exercise just FYI.

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Robbiecriss
I have read conflicting data on drinking caffeine and afib. Some have said it is a trigger and others say while it may exacerbate pac or pvc activity it is not an afib determinant. Anyone here have any advice or clear guidance. I must admit I do love my one cup of coffee or tea each day. Thanks in advance for your insights.
I had an afib ablation three years ago and have not had any sustained tachycardia since except in short bursts during exercise just FYI.

Seems to be individual. Over the years, some have found that organic coffee agrees with them while non organic doesn't. Below is from the Haywire Heart book:

Caffeine Oddly enough, caffeine’s relationship to rhythm problems is unclear. Old thinking had it that caffeine could cause or exacerbate rhythm problems. New data, including multiple large observational studies, suggest that caffeine does not associate with arrhythmias. In fact, the most provocative finding indicates that the favorite pick-me-up of so many athletes may actually confer a lower risk of arrhythmia. That’s not a misprint. It may sound strange, but it’s what the science shows. Here are a few of the largest studies on caffeine and heart disease: Caffeine and premature beats. In the largest study to evaluate the association of dietary patterns and heart rhythm problems, a group of US researchers published a report from the Cardiovascular Health Study, a longitudinal study sponsored by the National Institutes of Health of more than 5,000 older adults recruited from four academic medical centers. A longitudinal study means people sign up to have their health followed over long periods of time. (The most famous of these types of studies is the Framingham Heart Study mentioned in Chapter 4.) The research group found no relationship between caffeine consumption and the numbers of premature beats from the atria (PACs) or ventricles (PVCs). This non-relationship persisted after adjustment of possible confounding factors.2 Caffeine and AF. The evidence that caffeine does not associate with AF is even stronger. In 2013, a research team from Portugal culled together seven studies that included more than 115,000 individuals. They found that caffeine exposure was not associated with an increased risk of AF. What’s more, when only the highest-quality studies were considered, the researchers found a 15 percent reduction in AF with low-dose caffeine exposure.3 A larger study from a group of Chinese researchers confirmed these findings, including the same sign of AF protection with low-dose caffeine exposure.4 Caffeine and electrical properties of the heart. Caffeine exposure has been tested in a randomized clinical trial in patients with known arrhythmia. Canadian researchers studied 80 patients who were to have catheter ablation of supraventricular tachycardia (SVT). One hour before the procedure, half the group received caffeine tablets, and the other half received a placebo. Although caffeine increased blood pressure, it did not have any effects on the measured electrical properties of the heart.5 Caffeine and general cardiac health. The largest study on caffeine and heart disease included more than 1.2 million participants. In this case, researchers reviewed 36 studies from the literature and found that moderate coffee consumption (3 to 5 cups per day) associated with a lower risk for heart attack, stroke, or death related to heart disease.6 Yes, lower. An important caveat is that most of these studies look at populations, not individuals. That means that although certain people may not be sensitive to caffeine, others—perhaps, you—could be quite sensitive to it. We know this information sounds counterintuitive. We’ve heard from many athletes who feel less arrhythmia after reducing or eliminating caffeine intake. The confusing thing about heart rhythm problems is that it’s hard to sort out what caused the reduction in symptoms. Heart arrhythmias have natural variability, so it might be mere circumstance. Another possibility is that when people get a diagnosis of a heart problem, they adjust things besides caffeine consumption, such as the amount of training they do or sleep they get, or what they eat. Doctors call these things confounding factors. The caffeine revelation has caused a significant reversal in thinking. Doctors ask patients with arrhythmia to give up a lot: alcohol, training, stressful situations, and more. It’s nice that athletes can enjoy an espresso without guilt.


Case Christopher J.; Mandrola Dr. John; Zinn Lennard. The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart (pp. 131-133). VeloPress. Kindle Edition.

On exercise, I'm an advocate of Zone 2 training (more info here) as my hypothesis is it is less likely to cause issues AND the data suggest it can increase mitochondrial density up to 4x.

I've never seen compelling evidence that caffeine promotes or triggers AF, but I have seen compelling evidence that it's actually somewhat helpful.

And that pretty much sums up my opinion of caffeine and AF. I think avoiding it was advice dished out by doctors a century ago because it made logical sense to them, and it's been handed down from one generation to the next ever since as medical folklore with no actual evidence to support it.

But, as always with AF, some people will swear that a single cup of coffee or tea will set off their AF every time. Maybe, but when I've questioned people about that I almost always find out it happened once and they never touched caffeine again. So a one-time coincidence backed by 100 years of doctors preaching it as gospel pretty much seals the deal for a lot of people. For that reason, I don't trust anecdotal reports on this question much.*

I say drink all you want and if it doesn't agree with you, cut down or stop drinking it.

* Speaking of anecdotal reports, my sister was diagnosed with persistent AF in her early 40s. She chose to live with it and so became permanent AF. Despite her accepting a lifetime of AF, her cardiologist strongly advised her to avoid alcohol and caffeine completely and forever because... they caused AF. Think about that for a moment. She missed her morning coffee and her evening drink for 20 years because she was told they cause the thing she had accepted as permanent. She resumed both after she realized how silly that was, and she's been happily enjoying her morning coffee and evening drink ever since.

No "scientific" argument from me. I'd just say coffee has no effect on my Afib nor ectopics. I've tried coffeine-free diet for a couple of months, it didn't change anything.
I'm now just avoiding drinking more than half a dozen cups of coffee/day, for excess may have some irritating effects on my stomach and bladder.

With my history of afib and documented episodes (over 200), I never found a relationship between caffeine and afib. Before my first ablation and through 11 years of afib, the only apparent "trigger" I found was having two alcoholic drinks, which kicked off some afib. Never one drink. Alcohol or dehydration??

After my first and second ablations (13 years in between), I drink coffee every day and have a glass of wine every day with no afib issues.

Ken, about alcohol, I'd think it's likely an effect of dehydration and/ or electrolyte imbalance.
Like for you, just one glass doesn't seem bad. Two is one in excess for me.
What makes me think it's caused by dehydration is that the ectopics and/or afib come hours later. During the night. It's likely the alcohol isn't yet fully metabolized when going to bed. I need to drink water and urinate in the process and, of course, I don't spend the night doing that.

The evidence for caffeine not affecting or even lowering afib incidence in otherwise normal registries of study subjects is substantial. However, the evidence for caffeine not triggering afib in patients with existing afib is much less clear. In recent studies significant numbers of existing afibbers reported caffeine was a trigger, less so than alcohol, but ahead of exercise and fatigue. Many cardiologists believe that it is a trigger, based on observation and not indoctrination. I have read where they caution that such conclusions should be based on repeated trials.

I am skeptical that all these cardiologists aren't aware of and/or don't understand the current research, or that patients make an association once between coffee and afib swear off caffeine forever.

As for anecdotes, I have repeatedly found that caffeine > PACs > afib, so I stay away from it. I speculate that many of the posters here have vagally mediated afib and aren't sensitive to caffeine and there is no association. However, for adrenergic or mixed afib, the increased circulation of catecholamines associated with caffeine might well trigger afib. Perhaps it is a question of dose response and could be tested. Anyways, I wouldn't dismiss the connection.

In my case, I’m very, very sensitive to caffeine. My husband can tell when I’ve had it; my behavior is much more excitable and I can do laps around the block. Only problem is later (especially in the middle of the night), I wake up in an episode of a-fib. Sometimes overdoing it on booze will trigger it as well, especially palpitations! When I laid off the booze for a week my palpitations disappeared. When I resumed a “one drink a night” routine, my palpitations returned. Today I had caffeine and two beers. I’m up writing this post because, guess what,...I’m in a-fib. Darn booze and caffeine! Argh!

I wish I was 25 again! Never had to worry about any of this. I guess it’s just a part of aging—everyone is different and reaction from person to person varies dramatically!

Never been a coffee drinker. But it looks like Black Coffee by its self has all the health benefits. When people load it down with sugar and coffee creamer etc, most of the health benefits are go away.
Looks like Dr. Jack Wolfson was promoting some type of Coffee cure all in his email a few weeks ago. Did not open those emails up. I got on his email list when i attended his AF seminar a while back.
Here is something you may want to look into.
Coffee Butter / Butter Coffee. Bulletproof coffee. Just some of the names of it.
youtube video's about it. [www.youtube.com]
Coconut Oil and MCT Oil are very popular with it.

It is individual.

My experience, and I have repeated this multiple times, is that caffeine consumption will reliably result in PAC activity after about an hour or two. This is an established pattern with me. I suppose the only thing I could do would be to blind the study and have someone serve me a drink with unknown caffeine content to me and I report PAC activity in the hours following. I haven’t done this since I kind of know the answer but I admit it would be more scientific.

Bottom line, if you feel better avoiding caffeine then do so. Caffeine isn’t an essential vitamin.

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wolfpack
It is individual.

My experience, and I have repeated this multiple times, is that caffeine consumption will reliably result in PAC activity after about an hour or two. This is an established pattern with me. I suppose the only thing I could do would be to blind the study and have someone serve me a drink with unknown caffeine content to me and I report PAC activity in the hours following. I haven’t done this since I kind of know the answer but I admit it would be more scientific.

Bottom line, if you feel better avoiding caffeine then do so. Caffeine isn’t an essential vitamin.

The hardest thing to achieve while testing for potential triggers is taking each suspect individually.
Sometimes, it can be obvious: no caffeine, no alcohol = no AFib; caffeine or alcohol = AFib.
Sometimes, it can't.

I did an experiment for about 6 weeks in a row where I would drink half a can of Coca Cola at noon on a Sunday. I experienced runs of PACs from about 3-5 PM each and every time.

Now, I suppose I can’t completely rule out noon or Sunday as causes, but I’m going with caffeine.

Of course, I should repeat the experiment with Pepsi just to be fair.

Drinking coffee now and every morning. Never any ectopics/PACs after coffee or any other drink/food. Potassium and magnesium supplements knocked out abut 80% of past ectopics.

Thanks for all the responses. It helps just to know I am not the only one dealing with this question.