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Recommendations Regarding Dietary Intake and Caffeine and Alcohol Consumption in Patients With Cardiac Arrhythmias: What Do You Tell Your Patients To Do or Not To Do?

  • Arrhythmias (B Stambler, Section Editor)
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Opinion statement

The etiology of arrhythmias including atrial fibrillation is multifactorial. Most arrhythmias are associated with comorbid illnesses like hypertension, diabetes, thyroid disease, or advanced age. Although it is tempting to blame a stimulant like caffeine as a trigger for arrhythmias, the literature does not support this idea. There is no real benefit to having patients with arrhythmias limit their caffeine intake. Caffeine is a vasoactive substance that also may promote the release of norepinephrine and epinephrine. However, acute ingestion of caffeine (as coffee or tea) does not cause atrial fibrillation. Even patients suffering a myocardial infarction do not have an increased incidence of ventricular or other arrhythmias after ingesting several cups of coffee. Large epidemiologic studies have also failed to find a connection between the amount of coffee/caffeine used and the development of arrhythmias. As such, it does not make sense to suggest that patients with palpitations, paroxysmal atrial fibrillation, or supraventricular tachycardia, abstain from caffeine use. Energy drinks are a new phenomenon on the beverage market, with 30–50 % of young adults and teens using them regularly. Energy drinks are loaded with caffeine, sugar, and other chemicals that can stimulate the cardiac system. There is an increasing body of mainly anecdotal case reports describing arrhythmias or even sudden death triggered by exercise plus using energy drinks. Clearly, there must be more study in this area, but it is wise to either limit or avoid their use in patients with arrhythmias. Moderate to heavy alcohol use seems to be associated with the development of atrial fibrillation. The term “holiday heart” was coined back in 1978, to describe patients who had atrial fibrillation following binge alcohol use. Thus, it is reasonable to recommend to patients with arrhythmias that they limit their alcohol use, although unfortunately this treatment will likely not completely resolve their arrhythmia.

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Acknowledgments

Dr. Nipavan Chiamvimonvat has received a grant from the National Institutes of Health and the Veteran’s Administration. Richard Myers has received an HHMI Training Grant Fellowship.

Disclosures

No potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. Woodland Clinic Medical Group, 632 West Gibson Road, Woodland, CA, 95695, USA

    Kathryn A. Glatter MD

  2. Division of Cardiovascular Medicine, University of California, Davis, One Shields Avenue, GBSF 6315, Davis, CA, 95616, USA

    Richard Myers BS & Nipavan Chiamvimonvat MD

  3. Department of Veteran’s Affairs, Northern California Health Care System, Mather, CA, USA

    Nipavan Chiamvimonvat MD

Authors
  1. Kathryn A. Glatter MD
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  2. Richard Myers BS
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  3. Nipavan Chiamvimonvat MD
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Correspondence to Kathryn A. Glatter MD.

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Glatter, K.A., Myers, R. & Chiamvimonvat, N. Recommendations Regarding Dietary Intake and Caffeine and Alcohol Consumption in Patients With Cardiac Arrhythmias: What Do You Tell Your Patients To Do or Not To Do?. Curr Treat Options Cardio Med 14, 529–535 (2012). https://doi.org/10.1007/s11936-012-0193-6

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  • DOI: https://doi.org/10.1007/s11936-012-0193-6

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