Itoh Akira
Department of Cardiology, HITO Medical Center, 788-1, Kamibuncho, Shikokuchuo City, Ehime, Japan.
Eur Heart J Case Rep. 2022 Jun 28;6(7):ytac252. doi: 10.1093/ehjcr/ytac252. eCollection 2022 Jul.
Although there are many negative reports on coffee consumption and the occurrence of atrial fibrillation (AF), several factors are involved in the metabolism of caffeine, and it is possible that the response to caffeine changes with age. We present a case in which Apple Watch was useful in detecting very brief paroxysmal AF that was thought to be triggered by coffee consumption.
The patient was a man in his early 60s. He often drank a cup of coffee after breakfast. At some point, after drinking coffee and commuting to work, he noticed palpitations. He got an Apple Watch, and when he recorded his electrocardiogram when the symptoms occurred, he found that he had AF. During the following month, the frequency of AF was examined in relation to whether coffee was consumed in the morning. Twenty days of 28 days, coffee was consumed, and of these, AF was observed on 8 days (40%). In the 8 days when he did not drink coffee, there was no AF. For the next 28 days, the coffee was changed to decaffeinated coffee and the frequency of AF was examined. AF was observed on 5 of the 24 days when decaffeinated coffee was consumed (21%). AF did not occur on the 4 days when decaffeinated coffee was not consumed.
These results may indicate that AF was significantly more common on days when coffee was consumed. In the case of frequent but short-lasting AF, it is worth considering whether coffee consumption may be a trigger.
尽管有许多关于咖啡饮用与心房颤动(AF)发生的负面报道,但咖啡因的代谢涉及多个因素,并且对咖啡因的反应可能随年龄而变化。我们报告一例苹果手表有助于检测被认为由咖啡饮用引发的非常短暂的阵发性房颤的病例。
患者为一名60岁出头的男性。他经常在早餐后喝一杯咖啡。在某个时候,喝咖啡并通勤上班后,他注意到心悸。他买了一块苹果手表,当症状出现时记录心电图,发现自己患有房颤。在接下来的一个月里,根据早上是否喝咖啡来检查房颤的发作频率。28天中有20天喝了咖啡,其中8天(40%)观察到房颤。在不喝咖啡的8天里,没有房颤发作。在接下来的28天里,将咖啡换成了脱咖啡因咖啡并检查房颤发作频率。饮用脱咖啡因咖啡的24天中有5天(21%)观察到房颤。在未饮用脱咖啡因咖啡的4天里没有房颤发作。
这些结果可能表明饮用咖啡的日子里房颤明显更常见。对于频繁但持续时间短的房颤,值得考虑咖啡饮用是否可能是一个触发因素。