• Management of comorbidities and lifestyle factors such as physical inactivity and alcohol are the cornerstone of atrial fibrillation (AF) management. While caffeine is often considered as a risk factor for AF, evidence has so far been limited to mostly observational studies.
• Existing studies show mostly a neutral or beneficial effect of coffee with regards to AF, though these are observational and hence prone to confounders.
• The recent DECAF trial was the first randomized controlled trial (RCT) that tested this hypothesis in patients with persistent AF, and demonstrated a reduced recurrence of AF in patients randomized to daily coffee intake.
• Further evidence is needed regarding the effect of caffeine on paroxysmal AF. The effects of other caffeinated products such as energy drinks also require further research.
Atrial fibrillation (AF) is the most common cardiac arrhythmia, with a prevalence of 1.49 million people in England, and an estimated lifetime risk of 37% in those of European descent (1,2). Guidelines emphasise the importance of managing lifestyle factors such as obesity, physical inactivity and alcohol which have been proven to increase AF risk (2–4). While many patients (5) and physicians (6,7) consider caffeine to be a trigger for AF, there is a paucity of randomised controlled trial (RCT) data.
Author Sub-editor: Dr Pok-Tin Tang Dr Pok-Tin Tang is an ST5 cardiology registrar in the Thames Valley deanery, currently undertaking a period of out of
Author Sub-editor: Dr May Hu Dr May Hu is a cardiology trainee in the North West deanery. She graduated with First Class Honours from the University
Author Sub-editor: Dr Jhiamluka Solano Dr Jhiamluka Solano is a cardiology resident doctor (ST6) in the Yorkshire and Humber Deanery, currently undertaking a DPhil (PhD)
Author Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester
