KiTOMI: New Approach to Heart-Safe Sex

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Newman_061115_2One of the more frequent reports by heart patients is that fear of aggravating their condition leads to a change and decline in sexual activity. This is often due to self-imposed restrictions based on misconceptions about their relative risk. A new, comprehensive study has attempted to offer better guidelines to physicians so they can advise heart patients on what sexual activity can be available.

The guidelines rely on a new acronym, KiTOMI, which stands for kissing and touching, oral sex, masturbation, and intercourse. The KiTOMI model forms the basis of a “decision tree” that categorizes heart patients into low-risk, intermediate-risk, and high-risk groups. Advice is given on what conditions fall into each category and which KiTOMI activities can be safely engaged in.

The resulting KiTOMI decision tree is relatively simple. Following the assessment of the patient, doctors place them in the low-, intermediate-, or high-risk category and advise them of safe options. Low-risk patients have conditions unlikely to be aggravated during intercourse and can have the full KiTOMI spectrum available. Intermediate-risk means there is potential for intercourse to trigger symptoms and the need to settle for simply KiTOM (everything except intercourse) while undergoing cardiac rehabilitation. High-risk individuals have unstable heart diseases that are most likely to be triggered during intercourse. In addition to prioritizing ways to stabilize the condition, physicians are urged to counsel these individuals to restrict themselves to just KiT (kissing and touching).

As much as doctors will direct cardiac patients on the advisability of returning to work or enrolling in exercise programs, the study authors believe that similar advice should be offered regarding KiTOMI activities. Due to the subject’s sometimes taboo nature, few patients engage in sexual consultation with their doctor even after a heart attack episode. Noting that sexual activity “is often considered the most pleasant and rewarding exercise,” the authors hope their study equips physicians to better explain to and inform patients.

To improve clarity on the relative risk, the authors compared the cardiac impact of various types of walking to different forms of sexual activity. They note that the most intensive sexual activity on the heart (orgasm) was comparable to a fast-paced walk. In more absolute terms, they found that sudden cardiac death accounts for only two percent of exercise-related fatalities—with sexual activity accounting for an even lesser amount of the triggers. The numbers drop even lower when looking at younger or aerobic men, along with women in general.

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Sources for Today’s Article:
Stein, R., et al., “Sexual Activity and Heart Patients: A Contemporary Perspective,” Canadian Journal of Cardiology 2015; doi:

“What Sex Is Safe for Heart Patients: A New Approach Using the KiTOMI Model,” EurekAlert! web site, November 5, 2015;