One of my young patients, a 32-year-old professional with heart rhythm problems, asked me if he could resume drinking a cup or two of black coffee. Two years ago, he came to the emergency department with palpitations, dizziness, and shortness of breath. Then he told me that he had to finish a project in one night, and that he had several cups of black coffee to stay awake. Although he had no history of heart disease, the multiple cups of coffee he consumed acted as an excessive stimulant and led to a high and irregular heartbeat in the upper chambers of his heart or atria, which we call atrial fibrillation (A-Fib).
Now having a cup or two of black coffee is good for the heart. But taking a lot of it, without also milk, to mitigate the effects, acts as a stimulant drug and causes heart palpitations, as in my patient. For this reason, cardiologists limit coffee consumption in atrial fibrillation patients, believing that it may lead to an irregular heartbeat and raise the heart rate.
This was also confirmed by a new study presented at the American Heart Association Scientific Sessions. It was found that drinking a cup of coffee may protect people from irregular heartbeat. Although this may seem to challenge conventional wisdom, it is an observational study and is by no means excessive. In fact, he limits his consumption to a cup a day.
What does a new study say?
The Does Eliminating Coffee Prevent Fibrillation (DECAF) clinical trial found that 200 patients with persistent arrhythmia reported a “significantly” reduced risk of the condition reoccurring despite drinking coffee. During the six months following treatment to restore a normal heart rhythm, adults with atrial fibrillation who were randomly assigned to drink a cup of coffee every day were 39% less likely to have atrial fibrillation recur compared to participants who were assigned to drink no coffee or other caffeinated beverages.
The six-month trial included older people from the United States, Canada and Australia.
What is A-Fib?
Atrial fibrillation (A-fib) is an irregular and often rapid heartbeat (arrhythmia) in which the upper chambers of the heart beat erratically, causing them to quiver. In a normal heart, its upper and lower chambers contract in a regular, coordinated rhythm to pump blood. But when electrical signals in the atria become chaotic, the heart beats irregularly and often too fast.
This can lead to blood pooling and clots, increasing the risk of stroke, heart failure and other complications. Common symptoms include fluttering or pounding heartbeats, dizziness, and shortness of breath, although some people experience no symptoms at all. It is caused by excessive caffeine and alcohol consumption, dehydration, stress, lack of sleep and high blood pressure.
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It can be treated with medications and, in extreme cases, ablation, in which a catheter is guided into the heart to use heat or cold energy to create small scars that block false electrical signals. Sometimes an electric shock is delivered to the chest to reset the heart’s rhythm. Sometimes a patient may need a pacemaker.
Atrial fibrillation should be monitored because it causes strokes in the age group over 60 years.
Why is coffee under the scanner?
The caffeine in coffee is a stimulant that increases the secretion of adrenaline, which is the stress hormone. This makes your heart beat faster and increases your blood pressure. Also, it may take up to 10 hours or more for the body to completely eliminate the caffeine in one cup. Elevated stress hormones affect sleep quality, which is essential for protective heart health.
(Dr Shetty is Principal Cardiologist, Sparsh Hospitals, Bengaluru)
© Indian Express Company Limited
(tags for translation)Coffee consumption
