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Caffeine and Cardiac Arrhythmias

Martin G. Myers, MD
[+] Article and Author Information

Requests for Reprints: Martin G. Myers, MD, Division of Cardiology, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5.

Current Author Address: Dr. Myers: Division of Cardiology, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5.


©1991 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1991;114(2):147-150. doi:10.7326/0003-4819-114-2-147
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Purpose: To review the evidence supporting the belief that caffeine causes cardiac arrhythmias.

Data Sources: Studies published since 1982 identified through computerized searches of MEDLINE, TOXLINE, and Chemical Abstracts and a review of bibliographies of relevant articles on the subject of caffeine and cardiac arrhythmias.

Study Selection: All clinical studies examining caffeine as a cause of cardiac arrhythmias and a selection of basic science experiments to illustrate caffeine's effects in vitro.

Data Extraction: Study quality was assessed and all available clinical data pertaining to caffeine as a cause of arrhythmias were summarized.

Results of Data Analysis: In one electrophysiologic study, caffeine was associated with an increased susceptibility to provoked cardiac arrhythmias. In five placebo-controlled trials, caffeine in doses up to 500 mg daily (equivalent to 5 to 6 cups of coffee) did not increase the frequency or severity of ventricular arrhythmias. One large epidemiologic study reported an increase in the frequency of ventricular extrasystoles in persons consuming 9 or more cups of coffee daily.

Conclusion: Moderate ingestion of caffeine does not increase the frequency or severity of cardiac arrhythmias in normal persons, patients with ischemic heart disease, or those with pre-existing serious ventricular ectopy.

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