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'My heart would really bang for ten or 20 seconds,' said Chris Harmer
For most of us, coffee brings a pleasant, subtle sense of alertness — a clarity of mind, even.
But for Chris Harmer just one steaming cup is enough to make his heart jump and quiver at an alarming rate.
He’s so sensitive to it that even decaffeinated coffee causes a reaction.
‘People think decaf coffee contains no caffeine, but they’re wrong,’ laughs Chris, 66, a retired electronics engineer who lives with his wife, Pam, in Nailsworth, Glos.
Although most of the caffeine is removed from coffee beans to make decaf, studies show that around 1-2 per cent remains.
‘I have coffee from a particular roaster in Bristol because I get on with his decaf. Costa I get on with, too, but Starbucks is lethal. Chocolate’s bad, too.’
It’s not just the usual ‘wired’ caffeine feeling he has to worry about — Chris says caffeine triggers his atrial fibrillation (AF), a condition characterised by irregular heartbeat.
Thought to affect a million Britons, it’s caused by faulty electrical signals in the heart. Worryingly, it raises the risk of stroke five-fold and heart disease three-fold.
It’s therefore crucial that it is properly managed and treated — yet studies show there is an average delay of 2.6 years between symptoms starting and a person being diagnosed.
Indeed, although Chris’s symptoms started 15 years ago, he wasn’t diagnosed until 2008, with doctors at his local hospital writing it off as work stress.
‘My heart would really bang for ten or 20 seconds, and once it started it would go on every minute for hours,’ he says.
As many as 50 per cent of people with atrial fibrillation say that foods and drinks exacerbate their symptoms, and caffeine is among the most common
‘I realised that it was happening when I ate or drank certain things — and one of those things was caffeine.
'I had no idea of the stroke risk I faced,’ he says.
‘I took early retirement at 55 and wasn’t able to go hill walking, which is something I’d really enjoyed.
'As a result I was tending to put on weight, and . . . well, you tend to go a bit downhill. I think I was a bit depressed over it and my wife certainly had a lot of anxiety.
‘I’d read about atrial fibrillation, and got so fed up I went back to my GP and got him to refer me to the John Radcliffe Hospital in Oxford, where they finally diagnosed me.’
After finally getting a name for his condition, Chris has now been treated with cardiac ablation — an operation to burn away the nerves causing the faulty signals that trigger irregular beats.
He is also taking flecainide, a drug that regulates heart arrhythmias, and thankfully now has his condition under control.
But he remains vigilant about caffeine, avoiding not only coffee, but tea and soft drinks.
As many as 50 per cent of people with atrial fibrillation say that foods and drinks exacerbate their symptoms, and caffeine is among the most common, says Jo Jerrome, deputy chief executive of the Atrial Fibrillation Association.
But surprisingly, there’s little evidence to back up this perceived link.
‘We do see people who say that by stopping caffeine they’ve reduced their AF symptoms,’ says Clifford Garratt, professor of cardiology at Manchester University and Manchester Royal Infirmary.
‘But if you do strict trials of caffeine against non-caffeine it is difficult to show a difference in episodes.’
So, what exactly is going on? ‘My view is that people feel their arrhythmia more in the presence of caffeine because it increases the contractile strength of the heart,’ says Dr Andrew Grace, consultant cardiologist at Papworth Hospital, Cambridge.
This makes sense to Chris Harmer. ‘Now I’ve had the cardiac ablation operation and take the medication, normally I don’t get any fast heartbeats — which seems to make the effect from caffeine even more obvious.’
Caffeine is the most widely used psychoactive — or brain altering — drug in the world, with billions of us relying on it for a quick pick-me-up.
But its stimulating effect can have down-sides: aside from heart arrhythmias, the stimulant has also been linked with hypertension, migraines and sleep disorders such as insomnia.
Caffeine raises the heart rate and stimulates the nervous system, causing the release of adrenaline and the subsequent feeling of increased wakefulness.
It’s also known to constrict the coronary arteries, leading to a temporary rise in blood pressure.
Caffeine may cause migraines for the same reason — as it tightens the arteries, and then when the body is withdrawing from caffeine, the arteries dilate and the resulting excessive blood flow can cause a headache.
It’s thought to trigger restless legs syndrome, because of the stimulating effect it has on the nervous system.
Last year, it was reported that the England football squad needed sleeping pills after they took caffeine pills in preparation for a match against Poland.
Concerns have also been raised about the high levels of caffeine in energy drinks.
The U.S. Food and Drug Administration recently announced that it was investigating five deaths and one non-fatal heart attack that may have been linked to high levels of caffeine in energy drinks.
One of those who died was Anais Fournier, 14, who suffered a fatal heart arrhythmia after drinking two 24-ounce cans of Monster Energy on two consecutive days (the drink is not sold in the UK). Anais’s family have filed a lawsuit against its manufacturer.
Professor Garratt suspects that the recent deaths are cases of ventricular fibrillation — in which chaotic electrical activity causes the heart’s lower chambers to stop pumping, causing death (atrial fibrillation affects the upper chambers).
‘There are a number of rare genetic conditions affecting the heart that predispose patients to ventricular fibrillation,’ he says.
‘Often in these patients, exercise causes an abnormal response in the heart cells which can lead to ventricular fibrillation, and it’s possible caffeine could have the same effect.’
But the experts agree that when it comes to atrial fibrillation, a few coffees a day pose no threat — and may even be a force for good.
Research from the Women’s Health Study, a major study that has been following over 33,000 women since 1993, has found ‘elevated caffeine consumption was not associated with an increased risk of incident atrial fibrillation’.
Meanwhile, research recently published in the New England Journal of Medicine, which examined 229,119 men and 173,141 women, found ‘coffee consumption was inversely associated with total and cause-specific mortality’ — coffee drinkers were less likely to die early than non-coffee drinkers.
‘The common opinion is that coffee is bad,’ says Dr Grace. ‘The evidence we have is that caffeine has a neutral, and potentially protective, effect on arrhythmias.
‘Caffeine may, in occasional patients, trigger attacks, but it would appear not to shorten lives.
'This, of course, is good news for coffee drinkers.’
Jo Jerrome adds:
Jo Jerrome adds:
‘We recommend that once a person has seen a doctor and got a diagnosis of AF, they keep a diary to see if there is any pattern.’
Chris Harmer is happy to play it safe.
‘At heart rhythm conferences one hears that a certain amount of coffee can help, but we’re all different.
'I love my coffee but, luckily, you can get quite good decaf now.’
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