LONG viewed with suspicion by cardiologists, coffee may not be the heart rhythm risk many feared. A new multicentre clinical trial suggests that drinking caffeinated coffee could reduce the likelihood of recurrent atrial fibrillation (AF) after cardioversion, challenging long-held medical assumptions.
The World’s First Randomised Coffee Trial in Atrial Fibrillation
In this prospective, open-label randomised trial, 200 adults with persistent atrial fibrillation were enrolled across hospitals in the USA, Canada, and Australia. Participants were randomly assigned to either drink at least one cup of caffeinated coffee daily or abstain entirely from caffeine for 6 months following electrical cardioversion.
Coffee Drinkers Had 39% Lower Risk of Recurrence
By the end of the trial, 47% of participants in the coffee group experienced recurrent AF or atrial flutter compared with 64% in the abstinence group. This translated to a 39% lower hazard of recurrence (hazard ratio: 0.61; 95% CI: 0.42–0.89; p=0.01). No increase in adverse events was reported, suggesting that moderate coffee consumption is not only safe but potentially protective in AF management.
Rethinking Coffee and the Heart
These findings challenge the conventional belief that caffeine is proarrhythmic. Instead, caffeinated coffee may offer measurable benefits for patients recovering from atrial fibrillation. Researchers note that while moderation is key, avoiding coffee altogether may not be necessary, and could even be counterproductive, for heart rhythm stability.
Implications for Clinical Practice
This landmark study provides new evidence to guide cardiologists and patients alike. Encouraging moderate coffee intake could become part of a balanced lifestyle plan for those with a history of AF, marking a shift in how caffeine is viewed in cardiovascular care.
Reference
Wong CX et al. Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial. JAMA. 2025; DOI:10.1001/jama.2025.21056.
