For years, people thought that you needed to avoid coffee and caffeine with atrial fibrillation (AFib) for fear of your heart being thrown out of rhythm. But research suggests that the link between coffee and atrial fibrillation may be different than what we previously believed and that the sip may even protect against irregular heartbeats caused by AFib. Here’s what they found, plus the main limitations of the study and where more research might be needed.
The study, which was published in JAMA, enrolled 200 adults diagnosed with AFib who had an irregular, fast heart rhythm and were scheduled to be treated with cardioversion therapy, which involves medication or an electrical shock to try to restore a normal heart rhythm. Atrial fibrillation is a common heart rhythm disorder where the upper chambers of the heart beat irregularly and quickly, per the American Heart Association (AHA). If left unchecked, AFib may lead to blood clots, stroke, heart failure, and other heart-related complications. The most common symptoms include fatigue, rapid and irregular heartbeat, fluttering in the chest, dizziness, shortness of breath, weakness, faintness or confusion, fatigue during exercise, sweating, and chest pain, per the AHA.
Meet the experts: Nicholas Skipitaris, M.D., regional director for Cardiac Electrophysiology at Northwell Health in West Chester, NY; Alexa Mieses Malchuk, M.D., M.P.H., primary care physician at Geisinger Health in Pennsylvania; Peter R. Martin, M.D., professor of Psychiatry and Behavioral Sciences in the Department of Pharmacology at Vanderbilt University.
At the start of the study, the participants said they usually drank about one cup of caffeinated coffee a day. The researchers asked half of the participants to continue drinking at least one cup of coffee a day for six months, while the other half were asked to avoid all caffeine for the same time period.
The results challenged previous ideas that coffee may be “bad” for people with AFib. The researchers found that 47% of people in the coffee group had recurrent AFib episodes or atrial flutter (which is a rapid but regular heartbeat) lasting more than 30 seconds during the six-month study period, compared to 64% of those in the no-caffeine group. So, people in the coffee group had a 39% lower risk of an episode.
There were also similar reductions in episode risk when the researchers only looked at AFib episodes (excluding atrial flutters). This sounds like good news if you enjoy caffeinated drinks like coffee or tea, but doctors say there are a few things to consider before going all-in. Here’s what they want you to know.
What is the link between coffee and AFib?
The original idea of coffee impacting atrial fibrillation started from concerns around caffeine, said Nicholas Skipitaris, M.D., regional director for Cardiac Electrophysiology at Northwell Health in West Chester, NY. “Caffeine is a stimulant, and it can predispose you to having a heart rhythm that’s faster than normal,” he said. But that doesn’t seem to be the case for many people. (Older research has also found that people who drink coffee have a lower risk of AFib.)
If you’re a chronic coffee drinker, like the people in this study, it’s possible that your body simply gets used to the caffeine, Dr. Skipitaris said. “If your body gets used to it, it doesn’t have the same stimulant effect,” he explained. As a result, it may not rev up your heart when you drink the same amount each day.
This study also only looked at people who had about a cup of coffee a day—not loads of caffeine, pointed out Alexa Mieses Malchuk, M.D., M.P.H., a primary care physician at Geisinger Health in Pennsylvania. “As with anything, caffeine in moderation is fine for most people, depending on how much caffeine you’re consuming on a daily basis,” she said. “One cup of coffee is not likely to impact your heart rhythm.”
It’s a bit of a stretch right now to say that coffee is actually protective against atrial fibrillation, since this study was pretty small, Dr. Skipitaris said. (Bigger clinical trials are needed before scientists can make that declaration.) However, there are other compounds in coffee beyond caffeine, including chlorogenic acids, and those may be protective of your heart, said Peter R. Martin, M.D., professor of Psychiatry and Behavioral Sciences in the Department of Pharmacology at Vanderbilt University. “There’s a lot more to coffee than just caffeine,” he said.
The big takeaway—for doctors and patients—is that it’s “reasonable” for people with AFib who enjoy coffee to try caffeinated drinks, senior study author Gregory M. Marcus, M.D., M.A.S., a professor of medicine at the University of California, San Francisco, said in a statement.
Study limitations to note
It’s important to point out a few caveats here. One is that about half of the people who drank coffee still had AFib episodes, so coffee didn’t magically wipe out heart rhythm issues. Another is that about half of the people who participated in the study were taking medication to control AFib, and they continued to take it throughout the study. Finally, the study just looked at people who drank about a cup of coffee per day, making it hard to apply the results to people who drink more than that or who drink other caffeinated drinks like energy drinks.
As a result, it’s a stretch to say that having coffee alone will control AFib, Dr. Skipitaris said.
The bottom line
If you love coffee but have AFib, Dr. Malchuk said it’s best to have a conversation with your doctor about whether this is right for you. “Everyone is individual and has their own unique health concerns,” she said. “If you notice that one cup of coffee is having an impact on you, that may be a sign you shouldn’t drink as much caffeine.”
Some people with AFib may be OK with having two or more cups of coffee—it just depends on the person, Dr. Skipitaris said.
Ultimately, if you have AFib and enjoy coffee but are concerned about its impact on your heart, check in with your cardiologist. They can take a personal assessment and guide you from there.
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