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Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial.

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Caffeinated coffee consumption, averaging one cup daily, was linked to a reduced risk of atrial fibrillation (AF) recurrence compared to abstinence. This randomized trial challenges the notion that coffee is proarrhythmic for AF patients.

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Area of Science:

  • Cardiology
  • Clinical Trials
  • Electrophysiology

Background:

  • Conventional wisdom suggests caffeinated coffee is proarrhythmic.
  • Atrial fibrillation (AF) is a common arrhythmia, and coffee is a widely consumed beverage.
  • Previous randomized trials on caffeinated coffee and AF recurrence are lacking.

Purpose of the Study:

  • To investigate the effect of caffeinated coffee consumption versus abstinence on recurrent AF.
  • To assess the safety and efficacy of moderate daily caffeinated coffee intake in patients with AF.

Main Methods:

  • A prospective, open-label, randomized clinical trial involving 200 adults with persistent AF.
  • Participants were randomized 1:1 to consume caffeinated coffee or abstain from all caffeine for 6 months.
  • The primary endpoint was clinically detected recurrence of AF or atrial flutter.

Main Results:

  • AF or atrial flutter recurrence was lower in the caffeinated coffee group (47%) compared to the abstinence group (64%).
  • Caffeinated coffee consumption was associated with a 39% lower hazard of recurrence (HR, 0.61).
  • No significant difference in adverse events was observed between the groups.

Conclusions:

  • Moderate daily caffeinated coffee consumption may be associated with a reduced risk of AF recurrence.
  • This finding challenges the traditional view of coffee as proarrhythmic in AF patients.
  • Further research may explore the specific mechanisms underlying this association.