Screen Readers Skip to Content

KiTOMI Model: Safe Sex for Heart Patients

Author: Elsevier Health Sciences
Published: 6th Nov 2015 - Updated: 25th Oct 2022
Peer-Reviewed Publication: N/A
Additional References: Sexual Health Information Publications

Summary: KiTOMI model provides practical recommendations for healthcare providers counseling patients about sexual activity.


Main Document

New study published in the Canadian Journal of Cardiology dismisses myths and provides practical recommendations for healthcare providers counseling patients about sexual activity.

Changes in sexual satisfaction and decreases in sexual activity are often reported by heart patients. Both patients and partners may have misconceptions about the perceived dangers of sexual activities and commonly restrict their activities. However, in a new study in the Canadian Journal of Cardiology, researchers provide a comprehensive and updated review of the relevant literature and offer evidence- and expert-based practical recommendations regarding sexual activity in heart patients.

"Our extensive literature review enabled us to dismiss several myths regarding the advisability of sexual activity in heart patients," commented lead author Ricardo Stein, MD, DSc, of the Cardiology Division of the Federal University of Rio Grande do Sul, Brazil. "Overall, the risk of death during sex is very low for most clinically stable heart patients, and interestingly, even much lower for the women."

Sexual activity, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and rewarding form of exercise performed. Sexual activity is typically well-tolerated by most clinically stable heart patients, who are typically advised to participate in exercise programs as part of their recovery plan. Occurrence of sudden cardiac death is very rare, corresponding to less than 2% of all exercise-related deaths.

Counseling regarding how to gradually resume habitual sexual activity is critical for patients who have experienced a cardiac event or undergone a cardiac procedure.

Sexual activity encompasses several behaviors such as;

The authors propose the acronym KiTOMI to represent these behaviors.

"Our KiTOMI model will allow healthcare professionals to provide very simple and objective advice to their patients," explained lead investigator Claudio Gil S. Araújo, MD, PhD, of the Heart Institute Edson Saad, Federal University of Rio de Janeiro, and the Exercise Medicine Clinic - CLINIMEX. "In almost every case some type of sexual activity would be permitted. For patients whose condition is more debilitated, KiT would be the best initial option, progressively advancing to KiTOM until all KiTOMI activities are allowed."

Co-investigator, Aline Sardinha, PhD, also of the Federal University of Rio de Janeiro, noted that;

"Cardiac anxiety, the fear of cardiac-related stimuli and sensations, which are perceived as negative or dangerous, is common in heart patients and surely interfere with the resumption of a normal and regular sexual life."

The authors emphasize the importance of sexual counseling to provide reassurance and reliable information for patients and their partners, including the proper use of medications to treat erectile dysfunction.

Recommendations resulting from this study are summarized in the following Decision Tree, which evaluates the patient's heart condition according to widely-accepted definitions, places the patient in one of three risk groups, and defines the advisable sexual activities for each group.

Putting these recommendations into perspective, the researchers equated various sexual activities with walking at different speeds, noting for example that orgasm is equivalent to a brisk walk across a street.

"Professional sexual activity advice should be offered similar to advice regarding the return to work and enrollment in an exercise program," emphasized Dr. Araújo. "KiT activities should be a component of positive sexual behavior toward a healthier sexual life and should be recommended for virtually all heart patients regardless of sexual orientation. Often considered 'taboo,' an objective discussion of sexual behavior in heart disease has often been put aside. Healthcare providers must break this vicious cycle."

Post to Twitter Add to Facebook

Latest Sexual Health Information Publications

The above information is from our reference library of resources relating to Sexual Health Information that includes:

An illustration of two people with a hand holding the pride flag in the background. The Torres Strait Island, Aboriginal and Pride flags are also on the left side - Image Credit: Jacq Moon. thumbnail image
Barriers to accessing potentially life-saving support persist, according to new research into suicidality in the LGBTIQA+ community.
Publish Date: 7th Sep 2023
Health Studies Often Exclude Gender Diverse Impacting Health Care thumbnail image.
If researchers are serious about inclusive studies and surveys that focus on gender-diverse communities, they must measure both sex and gender.
Publish Date: 24th Apr 2023
Higher Risk of Sleep Problems in Gay, Lesbian, and Bisexual Youth thumbnail image.
Study finds depression, stress, and family conflict contribute to sleep problems in lesbian, gay, and bisexual youth.
Publish Date: 24th Mar 2023
Sexual Health Progress Score Card  thumbnail image.
The study proposes sexual health indicators to document public health needs and assess progress.
Publish Date: 10th Mar 2023


1How Many Genders Are There?
Alphabetical list of gender identities.

2Transgender Reporting Guide
How to write about transgender people.

3Glossary of Sexuality Terms
Definitions of sexual terms & acronyms.

4Glossary of Sexual Identities
Definitions of gender related terms.

5Am I Gay? Questions to Ask
Think you may be gay or bisexual?

• Submissions: Send us your coming events and LGBTQ related news stories.


• Report Errors: Please report outdated or inaccurate information to us.



• (APA): Elsevier Health Sciences. (2015, November 6). KiTOMI Model: Safe Sex for Heart Patients. SexualDiversity.org. Retrieved May 24, 2024 from www.sexualdiversity.org/sexuality/health/560.php


• Permalink: <a href="https://www.sexualdiversity.org/sexuality/health/560.php">KiTOMI Model: Safe Sex for Heart Patients</a>