Faculty Bibliography

To assess the role of ventricular premature beats in influencing mortality of coronary patients, 1739 men with prior myocardial infarction were monitored for ectopic activity for one hour at a standard base-line examination, and followed for mortality for periods up to four years (average, 24.4 months). Analyses of survival taking into account other important prognostic variables establish that the presence of complex premature beats (R on T, runs of 2 or more, multiform or bigeminal premature beats) in the monitoring hour is associated with a risk of sudden coronary death three times that of the men free of complex ventricular premature beats. The corresponding risk of death from any cause is twice that of men without such complex beats in the hour. These arrhythmias make an independent contribution to increased risk of death that persists over the length of this observation period

Three hundred thirty-five persons successfully detoxified from methadone hydrochloride maintenance were followed up for as long as six years to determine their ability to remain abstinent from narcotic use. At the end of the observation period, of the 269 persons located, 35% were narcotic-free, 58% had returned to narcotic use, and 8% were either jailed or deceased. The ability of a person to refrain from narcotic use was found to be highly associated with staff's assessment of progress and duration of methadone maintenance treatment. Relapse to narcotic use occurred regardless of length of abstinence, with 35% of relapses occurring after three or more years. While abstinence after narcotic dependency is possible, it is not a realistic goal for all. Premature detoxification from methadone maintenance is associated with a high recidivism rate to narcotics

Frequency and qualitative characteristics of ventricular premature beats (VPB) are determined from 1 hour of electrocardiogram (ECG) monitoring of men with coronary heart disease in a continuing study among members of the Health Insurance Plan of Greater New York. Mortality among 924 such men during an average observation period of 10 months was higher among men with VPB than among those free of VPB. In comparison with the routine 12-lead ECG, the hour of ECG monitoring increased the proportion of men identified as showing ectopic activity from 15% to 52%. Only half of men with 10 or more VPB in the hour of monitoring were noted as having VPB on the routine ECG; mortality among these men was relatively high whether or not VPB appeared on the short sample ECG