Consumption of Caffeinated Products and Cardiac Ectopy

Abstract

Background: Premature cardiac contractions are associated with increased morbidity and mortality. Though experts associate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) with caffeine, there are no data to support this relationship in the general population. As certain caffeinated products may have cardiovascular benefits, recommendations against them may be detrimental.

Methods and results: We studied Cardiovascular Health Study participants with a baseline food frequency assessment, 24-hour ambulatory electrocardiography (Holter) monitoring, and without persistent atrial fibrillation. Frequencies of habitual coffee, tea, and chocolate consumption were assessed using a picture-sort food frequency survey. The main outcomes were PACs/h and PVCs/hour. Among 1388 participants (46% male, mean age 72 years), 840 (61%) consumed ≥1 caffeinated product per day. The median numbers of PACs and PVCs/h and interquartile ranges were 3 (1-12) and 1 (0-7), respectively. There were no differences in the number of PACs or PVCs/h across levels of coffee, tea, and chocolate consumption. After adjustment for potential confounders, more frequent consumption of these products was not associated with ectopy. In examining combined dietary intake of coffee, tea, and chocolate as a continuous measure, no relationships were observed after multivariable adjustment: 0.48% fewer PACs/h (95% CI -4.60 to 3.64) and 2.87% fewer PVCs/h (95% CI -8.18 to 2.43) per 1-serving/week increase in consumption.

Conclusions: In the largest study to evaluate dietary patterns and quantify cardiac ectopy using 24-hour Holter monitoring, we found no relationship between chronic consumption of caffeinated products and ectopy.

Keywords: arrhythmia; diet; electrophysiology; epidemiology.

Figure 1

Estimated percent increase in cardiac ectopy for a serving per week increase in coffee, tea, or chocolate consumption. The unadjusted (white square) and adjusted (black square) estimates shown are after adjustment for clinic site, age, sex, race, income, education level, body mass index, dietary caloric intake, smoking status, number of alcoholic drinks per week, diabetes, hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, and use of β‐blockers, calcium channel blockers, digoxin, class I antiarrhythmics, and class III antiarrhythmics. Y error bars denote 95% CIs. PAC indicates premature atrial contraction; PVC, premature ventricular contraction; SVT, number of runs of supraventricular tachycardia; VT, number of runs of ventricular tachycardia.