How do you advise patients with paroxysmal atrial fibrillation regarding their caffeine consumption, given that a randomized clinical trial found no association between caffeine intake and the triggering of AF episodes?

There is no data to support that limited caffeine consumption should not be forced upon patients for AF prevention because it does not cause AF. Then again, there are patients who are sensitive to it and they should avoid it. I think patients are told to stop it because we want to blame something for their AF. We have enough other factors to treat (obesity, OSA, hypertension control, etc). AF happens to people, they don’t necessarily cause it. From here to Starbucks is a phrase I often use that pleases most patients who have AF despite having abandoned coffee at their doctors’ insistence. Just don’t go too wild with the coffee.