No Need to Give up Coffee after Cardioversion

It is commonly believed that caffeinated coffee has a proar-

rhythmic effect. A prospective, open-label, randomized study

investigated whether caffeinated coffee has an influence on

recurrent atrial fibrillation compared to abstinence from

coffee and caffeine. The study involved 200 coffee-drinking

adults or former coffee drinkers with persistent atrial fibril-

lation or atrial flutter with a history of atrial fibrillation who

were scheduled for cardioversion. After cardioversion, pa-

tients were instructed to either drink at least one cup of

coffee per day (n = 100) or to abstain completely from coffee

(including decaffeinated coffee) and caffeine (n = 100) for

six months. The primary endpoint of the study was the clin-

ically confirmed recurrence of atrial fibrillation or atrial flut-

ter over a period of six months.

Contrary to expectations, the recurrence rate in the cof-

fee-consuming group was lower than in the abstinence

group (47 vs. 64%), with a significant risk reduction of 39%,

especially for atrial fibrillation. A cup of coffee after cardio-

version is therefore not harmful and does not need to be

discouraged. No significant difference in adverse events

was observed. 

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Source: Wong CX et al.: Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomised Clinical Trial. JAMA. 9 November 2025:e2521056. doi:10.1001/jama.2025.21056

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