title: Consumption of Caffeinated Products and Cardiac Ectopy.
abstract: BACKGROUND
  Premature cardiac contractions are associated with increased morbidity and mortality. Though experts associate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) with caffeine, there are no data to support this relationship in the general population. As certain caffeinated products may have cardiovascular benefits, recommendations against them may be detrimental.
  
  
  RESULTS
  We studied Cardiovascular Health Study participants with a baseline food frequency assessment, 24-hour ambulatory electrocardiography (Holter) monitoring, and without persistent atrial fibrillation. Frequencies of habitual coffee, tea, and chocolate consumption were assessed using a picture-sort food frequency survey. The main outcomes were PACs/h and PVCs/hour. Among 1388 participants (46% male, mean age 72 years), 840 (61%) consumed ≥1 caffeinated product per day. The median numbers of PACs and PVCs/h and interquartile ranges were 3 (1-12) and 1 (0-7), respectively. There were no differences in the number of PACs or PVCs/h across levels of coffee, tea, and chocolate consumption. After adjustment for potential confounders, more frequent consumption of these products was not associated with ectopy. In examining combined dietary intake of coffee, tea, and chocolate as a continuous measure, no relationships were observed after multivariable adjustment: 0.48% fewer PACs/h (95% CI -4.60 to 3.64) and 2.87% fewer PVCs/h (95% CI -8.18 to 2.43) per 1-serving/week increase in consumption.
  
  
  CONCLUSIONS
  In the largest study to evaluate dietary patterns and quantify cardiac ectopy using 24-hour Holter monitoring, we found no relationship between chronic consumption of caffeinated products and ectopy.
authors.affiliation: University of California, San Francisco, San Francisco, CA (S.D., J.W.D., E.V., G.M.M.).
authors.forename: Shalini
authors.initials: S
authors.lastname: Dixit
authors.affiliation: Washington University School of Medicine, St. Louis, MO (P.K.S.).
authors.forename: Phyllis K
authors.initials: PK
authors.lastname: Stein
authors.affiliation: Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR (T.A.D.).
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Dewland
authors.affiliation: University of California, San Francisco, San Francisco, CA (S.D., J.W.D., E.V., G.M.M.).
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Dukes
authors.affiliation: University of California, San Francisco, San Francisco, CA (S.D., J.W.D., E.V., G.M.M.).
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: University of Washington and Group Health Research Institute, Seattle, WA (S.R.H.).
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.affiliation: University of California, San Francisco, San Francisco, CA (S.D., J.W.D., E.V., G.M.M.).
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Marcus
mesh_terms: D000368:Aged; D018880:Atrial Premature Complexes / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D002099:Cacao / Q000009:adverse effects*; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects*; D003069:Coffee / Q000009:adverse effects*; D004032:Diet / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory; D005247:Feeding Behavior; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D064167:Recommended Dietary Allowances; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013662:Tea / Q000009:adverse effects*; D013997:Time Factors; D014481:United States; D018879:Ventricular Premature Complexes / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D003069:Coffee; D013662:Tea; D002110:Caffeine
keywords: arrhythmia; diet; electrophysiology; epidemiology
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