Nov. 11, 2025

DECAF - A cup of coffee a day could keep atrial fibrillation from coming back

According to presentations at theThe first randomized trial comparing caffeinated coffee to no caffeine found that drinking at least one cup of caffeinated coffee daily reduced the risk of recurrent AFib by 39% compared to abstaining from coffee and other caffeinated drinks. Most, but not all, observational studies report neutral or beneficial associations of coffee and AFib, although conventional wisdom suggests that caffeine and other lifestyle choices can trigger AFib.

The first randomized trial comparing caffeinated coffee to no caffeine found that drinking at least one cup of caffeinated coffee daily reduced the risk of recurrent AFib by 39% compared to abstaining from coffee and other caffeinated drinks. Most, but not all, observational studies report neutral or beneficial associations of coffee and AFib, although conventional wisdom suggests that caffeine and other lifestyle choices can trigger AFib.

“These results really do have immediate application for patients as we still very commonly advise patients to avoid or reduce coffee and caffeine to try to minimize the effects of AFib and other arrhythmias,”** said Christopher X. Wong, MBBS, MPH, PhD, formerly of the University of California San Francisco, and now professor of cardiology at the University of Adelaide in Australia. **“Now we have the first randomized data suggesting that not only is caffeinated coffee not harmful but potentially beneficial. This will be delightful to the many patients who love their coffee.”

Patients with AFib commonly identify coffee as a trigger for AFib episodes, Wong said. A prior study from the University of California San Francisco showed that about 25% of patients identify coffee as an AFib trigger, second only to alcohol, identified by about a third of patients.

The DECAF trial randomized 200 patients in Australia, Canada and the United States with persistent AFib scheduled to undergo electrical cardioversion to at least one cup of caffeinated coffee daily, based on their usual lifestyle, or no coffee or other caffeinated products.

The mean age of patients was the late 60s, about 70% were male, and the mean body mass index was 30. Cardiovascular comorbidities were common. The median time from AFib diagnosis was two years, and many were on antiarrhythmic medications or had undergone prior AFib ablation.

The primary endpoint was clinically detected recurrence of AFib or atrial flutter lasting at least 30 seconds at six months following electrical cardioversion.

Secondary endpoints included the separate recurrence of AFib or atrial flutter, and adverse events, including major atherosclerotic events, emergency department visits, hospitalization or death.

Individuals who drank at least one cup of caffeinated coffee daily were significantly more likely to be free of AFib over the follow-up period, HR 0.61 (95% CI: 0.42 to 0.89, p=0.10).

Abstinence from caffeine was not perfect with just 69% of those in the abstinence group reporting no coffee consumption over the entire six months. In a specified subgroup analysis, complete abstinence from caffeinated coffee led to HR 0.53 from freedom from AFib (95% CI: 0.36 to 0.78, p=0.002).

There was a lower, nonsignificant reduction in atrial flutter in the abstinence group and no difference between the groups in adverse events.