Researchers examined data on 4,557 adults who died from a sudden cardiac arrest, which is essentially a short circuit in the heart's electrical system. They found just 34 cases linked to sexual activity.
Put another way, less than 1 percent of the deaths from sudden cardiac arrest were related to sex.
"Based on this data we now know that the likelihood of sex being a trigger for sudden cardiac arrest is extremely low," senior study author Dr. Sumeet Chugh, of the Cedars-Sinai Medical Center Heart Institute in Los Angeles, said by email.
Chugh and colleagues reported their findings at the American Heart Association's Scientific Sessions meeting in Anaheim, California, and online in the Journal of the American College of Cardiology.
Cardiac arrest involves the abrupt loss of heart function, breathing and consciousness. Unlike a heart attack, which happens when blood flow to a portion of the heart is blocked, cardiac arrest occurs when the heart's electrical system malfunctions, often due to irregular heart rhythms. Cardiac arrest may occur with no warning and is often fatal if not treated within minutes.
Cardiac arrest results in more than 300,000 deaths each year in the U.S. alone, the researchers say.
For the study, researchers looked at detailed medical reports for all of the adults who died in Portland, Oregon, from 2002 to 2015. They had access to complete medical histories and autopsy records, as well as any information about what patients were doing when the cardiac arrest occurred.
Patients who experienced sudden cardiac arrest linked to sexual activity had higher rates of what's know as ventricular fibrillation - a serious cardiac rhythm disturbance - and tachycardia, or a higher-than-normal heart rate.
Most of the cases were men with a history of heart disease.
Only about 1 in 100 men and 1 in 1,000 women experience sudden cardiac arrest during sexual activity, the study found.
Patients who had sex before they went into cardiac arrest tended to be about 60 years old on average, compared to around 65 for the patients who were doing other things when their heart stopped beating.
When sex preceded cardiac arrest, survival odds tended to be a bit better. Nearly 20 percent of people survived in sex-related cases, compared to only about 13 percent survival odds for other patients.
Survival often depends on how quickly patients receive cardiopulmonary resuscitation (CPR), or chest compressions, which can help restore circulation and maintain blood flow to vital organs.
All of the patients in the study had their cardiac arrest witnessed by another person, but less than one third of them received CPR.
Odds of CPR were better, however, in sex-related cases. Roughly 32 percent of patients who had sex-related cardiac arrests received CPR, compared with 27 percent of the other cases.
The study wasn't a controlled experiment designed to prove whether or how sex might contribute to the odds of experiencing or surviving sudden cardiac arrest. Researchers also didn't report on what type of sexual encounters occurred, making it difficult to determine how strenuous the activity may have been for patients.
Generally, older adults who are healthy enough for sex also probably have healthy blood vessels, said Dr. Venu Menon, a director of the cardiac intensive care unit at Cleveland Clinic in Ohio.
When sex-related cases of cardiac arrest do occur, it's possible the patients might have had undiagnosed or untreated coronary artery disease, Menon, who wasn't involved in the study, said in a phone interview.
"It would be irresponsible to say every 60 year old out there should start being concerned whether sex might put them at risk," Menon added. "What it does say is that if you are sexually active you should be conscious of your health and if you have any shortness of breath or chest pain you should see a doctor."
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