Does Coffee Prevent Recurrence of Atrial Fibrillation?

Here’s a great question: does drinking coffee with caffeine prevent recurrent atrial fibrillation?

Historically people have believed that caffeine leads to tachycardia and possibly arrhythmias, including atrial fibrillation. But it that really the case? In this study, researchers enrolled 200 people who drank an average of about 1 cup of caffeinated coffee or tea each day. Everyone had atrial fibrillation, or atrial flutter with a history of atrial fibrillation, and was planning on having cardioversion. Mean age was 69, and 71% were men.

They were randomized to continue drinking caffeinated beverages, or avoid caffeine altogether. During the next 6 months, one group continued to average one cup of caffeinated coffee or tea daily, while the other group had essentially none.

During the next 6 months, atrial fibrillation recurred in 64% of the patients who stopped caffeine, and in only 47% of the group that continued drinking caffeine. The difference is statistically significant.

This tells us that if someone drinks caffeinated beverages and has a cardioversion for atrial fibrillation, they should probably continue drinking caffeinated beverages, they likely have a decreased risk of going back into atrial fibrillation. 

One cup of coffee a day is a relatively small amount. Would the differences be more profound if they consumed 3-4 cups a day, or even more? I have seen other studies showing that consuming larger amounts of coffee is associated with a decreased risk of developing tachyarrhythmias, so maybe there is a dose-dependent response.

And what about people with atrial fibrillation that don’t drink caffeinated beverages. If they have a cardioversion, should they start? I don’t think we know the answer to that question, maybe these researchers will look at that next.    

Reference: Wong et al. Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation - The DECAF Randomized Clinical Trial JAMA 2025 Nov. 9; Online ahead of print