Caffeinated Coffee Consumption and Atrial Arrhythmia Recurrence After Pulmonary Vein Isolation

Background: The impact of caffeinated coffee consumption on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) remains uncertain, and clinical recommendations regarding caffeine intake are inconsistent. Methods: This retrospective observational cohort study included consecutive patients undergoing first-time PVI using a high-power short-duration technique between 2019 and 2023. Patients were stratified according to self-reported daily coffee consumption into a high-consumption group (≥2 cups/day) and a low-consumption group (0-1 cup/day). The primary endpoint was recurrence of atrial arrhythmia within 12 months after PVI, excluding a 90-day blanking period. Multivariable logistic regression was performed to assess the association between coffee consumption and arrhythmia recurrence. Results: A total of 199 patients were included, of whom 124 (62.3%) reported high coffee consumption and 75 (37.7%) low consumption. Baseline characteristics and procedural parameters were comparable between groups. At 12 months, atrial arrhythmia recurrence occurred in 24 patients (19.4%) in the high-consumption group and 25 patients (33.3%) in the low-consumption group (p = 0.03). In multivariable analysis, higher coffee consumption was independently associated with a lower risk of recurrence (adjusted OR 0.47, 95% CI 0.23-0.95; p = 0.036). Conclusions: In patients undergoing first-time PVI, higher habitual consumption of caffeinated coffee was associated with a lower risk of atrial arrhythmia recurrence within one year. These findings suggest that moderate coffee consumption may be safely permitted and need not be routinely restricted in this setting. Further prospective studies are warranted to clarify whether this association is causal.