CRAVE: A Closer Look at Coffee Consumption and Real-Time Atrial and Ventricular Ectopy

Coffee consumption resulted in more premature ventricular contractions (PVCs) and less sleep, but no increase in atrial arrhythmias and an increased amount of physical activity, according to findings from the CRAVE trial presented Nov. 14 during AHA 2021. "These data add to the growing evidence that those with supraventricular tachycardia or atrial fibrillation or at risk for those diseases should not necessarily avoid coffee," researchers said.

The trial, presented by Gregory M. Marcus, MD, MA, FACC, enrolled 100 adults, of whom the median age was 38 years, 51% were women and 48% were non-Hispanic White. Each participant was fitted with a continuously recording ECG device, a continuous glucose monitor and a Fitbit. Researchers used a smartphone mobile application to collect geolocation data and DNA from each participant was genotyped for caffeine metabolism-related single nucleotide polymorphisms. Participants were randomized to consume or avoid coffee each day for 14 days and received daily texts and reminders.

Overall results found random assignment to coffee consumptions was associated with a 54% increase in PVCs; 36 fewer minutes of sleep per night; and 1,058 additional Fitbit-based steps per days. Each additional cup of coffee was associated with 3% more daily premature atrial contractions and 18 fewer minutes asleep per night. No significant differences in glucose levels and no increase in atrial arrhythmias were observed. Researchers did note that faster caffeine metabolizers experienced heightened PVCs, while slower caffeine metabolizers experienced the greatest impact on sleep.

"The acute yet every-day physiologic effects of coffee are complex," said Marcus. He suggested that those prone to PVCs or ventricular arrhythmias may benefit from coffee abstinence, but also noted that genetic differences influence risk. Additionally, he cautioned that while findings did show coffee consumption enhanced overall physical activity, "this must be weighed against the risks associated with reduced sleep."

Keywords: AHA Annual Scientific Sessions, American Heart Association, AHA21, Heart Atria, Electrocardiography

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