The complex relationship between caffeine and arrhythmias

Anna Vittoria Mattioli¹, Milena Nasi¹, Silvia Toni², Alberto Farinetti³

¹Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine (University of Modena and Reggio Emilia, Italy - ²Department of Diagnostics, Clinical and Public Health Medicine (University of Modena and Reggio Emilia, Italy - ³Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy

Introduction: The relationship between caffeine and arrhythmias is controversial. Several studies have been performed to evaluate the potential pro-arrhythmic effects of caffeine leading to opposite conclusion. The aim of the present commentary was to evaluate the relationship between arrhythmias and caffeine.

Materials and methods: The present review analyzes pre-clinical and clinical studies evaluating the relationship between caffeine and arrhythmias, with a look at the effects of highly caffeinated beverages.

Results: A difference has been reported between the effect of daily coffee consumption and  high acute caffeine intake as happened in energy drink ingestion. Caffeine might not be arrhythmogenic except at very high doses and in subjects with high sensitivity, however the mix of caffeine and other substances such as guaranine or taurine could enhance the trigger of arrhythmias.

Conclusions: In conclusion caffeine at regular dose is not associated with arrhythmias. On contrary intake of high quantity of caffeine (i.e. highly caffeinated beverages) could trigger the development of arrhythmias.