—A description of the differences between the study1 cited by Dr Hellerstein and our article will help explain our differing recommendations. In the cited study, sexual activity was documented to produce only minimal hemodynamic and ECG changes among cardiac patients. This study did not assess the occurrence of MI, a more important outcome, and did not survey a large population. Because of the scope of that study, the recommendation was made to consider home ECG monitoring of cardiac patients during sexual activity before considering it safe for them to resume that activity.We believe that such monitoring is not necessary because of the results of our present study. In contrast to prior studies, we assessed the risk of MI caused by sexual activity in a large population. Although none of these patients underwent monitoring during sexual activity to determine safety, the absolute risk was quite small. It is
Muller JE, Mittleman MA. Sexual Activity and Risk of Myocardial Infarction-Reply. JAMA. 1996;276(10):783. doi:10.1001/jama.1996.03540100027020
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