Long-term outcome with the automatic implantable cardioverter-defibrillator

AbstractThe automatic implantable cardioverter-defibrillator was implanted in 270 patients because of life-threatening arrhythmias over a 7 year period. There was a history of sustained ventricular tachycardia or fibrillation, or both, in 96% of these patients, 80% had one or more prior cardiac arrests and 78% had coronary artery disease as their underlying diagnosis. The average ejection fraction was 34%, and 96% of these patients had had an average of 3.4 antiarrhythmic drug failures per patient before defibrillator implantation. There were four perioperative deaths and eight patients had generator infection or generator erosion, or both, during the perioperative period or during long-term follow-up. Concomitant antiarrhythmic drug therapy was given to 69% of patients.Shocks from the device were given to 58% of patients, and 20% received “problematic” shocks. The device was removed from 16 patients during long-term follow-up for a variety of reasons. There were 7 sudden cardiac deaths and 30 nonsudden cardiac deaths, 18 of which were secondary to congestive heart failure. The actuarial incidence of sudden death, total cardiac death and total mortality from all causes was 1%, 7% and 8%, respectively, at 1 year, and 4%, 24% and 26% at 5 years.The automatic implantable cardioverter-defibrillator nearly eliminates sudden death over a long-term follow-up period in a high risk group of patients. It has an acceptable rate of complications or problems, or both, and most late deaths in these patients are nonsudden and of cardiovascular origin

Differential positronium-formation cross sections for Ne, Ar, Kr, and Xe

Experimental determinations of the absolute differential positronium-formation cross sections near 0∘ for Ne, Ar, Kr, and Xe are presented and compared with theory. The degree of forward collimation, expressed by the ratios of the differential-to-integral positronium-formation cross sections, is also computed and compared with theories and other targets. Trends among targets and structures at low energies emerge when considered as a function of the reduced total energy.The Engineering and Physical Sciences Research Council is gratefully acknowledged for supporting this work under Grant No. EP/P009395/1 and for providing S.E.F., M.S., and D.M.N. with research studentships. T.J.B. is grateful for The Robert and Helen Crompton Award

Biological activity of two isomeric N-heteroaromatic selenosemicarbazones and their metal complexes

New square-planar Pd(II) and Pt(II) complexes with 8-quinolinecarboxaldehyde selenosemicarbazone have been synthesized and characterized by use of elemental analysis, molar conductivity measurements, and IR and NMR spectroscopy. The cytotoxic activity of the ligand, new Pt(II) and Pd(II) compounds, and previously synthesized Pd(II), Pt(II), Cd(II), and Ni(II) complexes with the analogous ligand, 2-quinolinecarboxaldehyde selenosemicarbazone, was tested against two human cancer cell lines: lung carcinoma (H460) and glioma (U251). The potential of these compounds to induce perturbations of the H460 cell cycle was also evaluated. These substances had an excellent radical-scavenging effect against ABTS radical cations. The best antimicrobial activity, among two yeasts and eight bacterial strains tested, was against Bacillus cereus