To coffee lovers:
Does Coffee Promote Atrial Ectopy?
Molly S. Brett, MD, reviewing Marcus GM et al. N Engl J Med 2023 Mar 23
Caffeinated coffee was not associated with premature atrial contractions in this small, randomized trial.
Although many people believe that caffeinated coffee can cause cardiac ectopy, prior studies (mostly observational) have cast doubt on this alleged relation. In this randomized case-crossover study, 100 healthy adults (mean age, 39) without atrial fibrillation or heart failure wore continuous-recording electrocardiogram (ECG) patches and wrist accelerometers for 14 days. During this time, they were instructed randomly by text message to consume caffeinated coffee or avoid all caffeine during 2-day periods, resulting in 7 coffee-drinking periods and 7 no-caffeine periods. Participants pressed a button on their ECG patch when each coffee drink was consumed and filled out daily surveys about consumption.
At baseline, most participants consumed <1 cup of coffee daily. During the study, when participants were assigned to drink coffee, most drank 2 to 3 cups daily. The number of daily premature atrial contractions (PACs) was nearly identical on days with or without caffeinated coffee consumption (mean, 58 vs. 53 PACs daily). In exploratory analyses, more premature ventricular contractions (PVCs) occurred on coffee-drinking days (mean, 154 vs. 102 daily). Participants had higher step counts (≈1000 more steps) and less sleep (≈30 minutes less) on days they consumed coffee.
COMMENT
This trial provides further evidence that moderate coffee drinking is unlikely to cause atrial ectopy in healthy patients. The clinical significance of the small increase in daily PVCs observed on coffee-drinking days is uncertain. For healthy people, it's reasonable to leave decisions about coffee consumption to personal preference.