{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:46:34Z","timestamp":1791971194286,"version":"4.3.4"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"\n Importance<\/jats:title>\n Conventional wisdom holds that caffeinated coffee is proarrhythmic. Coffee is the most commonly consumed caffeinated beverage in the US, and a randomized trial assessing caffeinated coffee consumption in patients with atrial fibrillation (AF) has not previously been performed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the effect of caffeinated coffee consumption compared with abstinence from coffee and caffeine on recurrent AF.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a prospective, open-label, randomized clinical trial enrolling 200 current or previous (within past 5 years) coffee-drinking adults with persistent AF, or atrial flutter with a history of AF, planned for electrical cardioversion from 5 hospitals in the US, Canada, and Australia between November 2021 and December 2024. The date of final follow-up was June 5, 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Patients were randomized in a 1:1 ratio to regular caffeinated coffee consumption vs coffee and caffeine abstinence for 6 months. Patients in the coffee consumption group were encouraged to drink at least 1 cup of caffeinated coffee daily. Patients in the abstinence group were encouraged to completely abstain from both caffeinated and decaffeinated coffee and other caffeine-containing products.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary end point was clinically detected recurrence of AF or atrial flutter over 6 months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Two hundred patients (mean [SD] age, 69 [11] years; 71% male) were randomized to caffeinated coffee consumption (n\u2009=\u2009100) or coffee abstinence (n\u2009=\u2009100). Baseline coffee intake was 7 cups (IQR, 7-18) per week in both groups. During follow-up, coffee intake in the consumption and abstinence groups was 7 (IQR, 6-11) and 0 (IQR, 0-2) cups per week, respectively, resulting in a between-group difference of 7 cups (95% CI, 7-7) per week. In the primary analysis, AF or atrial flutter recurrence was less in the coffee consumption (47%) than the coffee abstinence (64%) group, resulting in a 39% lower hazard of recurrence (hazard ratio, 0.61 [95% CI, 0.42-0.89];\n P<\/jats:italic>\n \u2009=\u2009.01). A comparable benefit of coffee consumption was observed with AF recurrence only. There was no significant difference in adverse events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this clinical trial of coffee drinkers after successful cardioversion, allocation to consumption of caffeinated coffee averaging 1 cup a day was associated with less recurrence of AF or atrial flutter compared with abstinence from coffee and caffeinated products.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05121519<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.21056","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T15:30:19Z","timestamp":1762702219000},"page":"317","source":"Crossref","is-referenced-by-count":32,"title":["Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation"],"prefix":"10.1001","volume":"335","author":[{"given":"Christopher X.","family":"Wong","sequence":"first","affiliation":[{"name":"Division 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