I have a question regarding coffee and palpitations. That is the first thing the emergency doctor will ask you when you show up there with palpitations. "Do you drink a lot of coffee?"

I have heard that caffeine is a cardiac stimulant, and that would be the reason for the increase in palpitations. Would caffeine have any effect on vagus nerve events then?

On a somewhat related note, as mentioned last July, I went into AF early in the morning while waking up. I had already experienced palpitations prior to that, so I went off coffee altogether. So coffee could not have been a trigger for the AF episode.

I am really missing it and want to go back to drinking a cup or two a day, but I am afraid to slip back in to AF, which will set off my anxiety even more.

Dr Rane, what is your take on coffee and rhythm disturbances? Both my cardiologist and GP told me I should be fine to have a coffee or two, but I haven't tried yet.

Okay, caffeine is a central nervous system stimulant rather than specifically a cardiac stimulant. The heart reacts to the state of the nervous system, both sympathetic and parasympathetic. Stimulants induce artificial change to the nervous system that normally take place by sensory feedback both internally and from the environment.

A reduction in stimulants correlates with a reduction in stress upon the nervous system and secondarily, reduction in cardiac reactivity to the changes.

Best regards,

Rutheford Rane, MD (ret.)