Coffee and the Heart: Is caffeine a trigger for AFib?

About this episode

Does coffee trigger atrial fibrillation — or have doctors been warning people away from caffeine without strong evidence? We dig into two recent randomized clinical trials testing whether caffeinated coffee causes dangerous heart rhythm problems. Along the way, we talk about AFib, survival analysis, intention-to-treat versus as-treated analyses, and one surprisingly elaborate effort to catch clinical trial cheaters with receipts and geolocation tracking. We also explore how a pope may have fueled a European coffee resurgence, why plants make caffeine, and how a game show competition explains hazard ratios. Statistical topics • adherence and compliance • as-treated analysis • confidence intervals • Cox proportional hazards regression • hazard ratios • intention-to-treat analysis • micro-randomization • multiple testing • PICOT • pre-registration • primary vs secondary outcomes • randomized clinical trials • sensitivity analyses • SMART framework • survival analysis Methodological morals • “Never trust conventional wisdom until you see the randomized controlled trial.” • “Trust your participants, but design the study so that they can be honest about their dishonesty.” R