Aim:To investigate the effect of smoking and smoking cessation on cardio-ankle vascular index (CAVI). Methods: The subjects were 82 smokers (77 men, 64 10 years) and 20 non-smokers (18 men, 61 7 years). CAVI was measured every 3 months and CAVI severity was classified into 3 levels. Decreased, unchanged, and increased CAVI severity levels were coded as "improvement," "no change," and "exacerbation," respectively. Smoking status was coded as "success" for complete abstinence, "partial success" for a reduced number of cigarettes, and "failure" for an unchanging number of cigarettes. Results: Compared with non-smokers, smokers showed a higher CAVI (p 0.05) prior to smoking cessation. Post-cessation, CAVI improved from 9.4 to 8.6 (p 0.01) in "success" cases (n 22), and the significant pre-cessation difference from non-smokers (n 20, CAVI 8.8) disappeared. With regard to the change in CAVI severity of each smoking status, "improvement" occurred in 17%, 24%, and 68% of "failure" (n 35), "partial success" (n 25), and "success" (n 22) groups, respectively, and the "success" group was significantly higher than the other two groups. Conclusion: The study showed that CAVI was increased by smoking, and complete smoking cessation improved CAVI. J Atheroscler Thromb, 2010; 17:517-525.

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Clinically and theoretically, the left axilla was shown to be an improved ICD implantation site that may reduce DFT and lessen myocardial damage due to shock. Lower DFT also facilitates less myocardial damage, as a result of the lower shock required.

The left axillary generator implantations may reduce the mental burden and cause no safety concerns, and may be performed if functional or cosmetic outcomes are required.