Summary:We studied the effect ofcurrent smoking habits in the period immediately before admission to hospital in 90 consecutive patients presenting with chest pain, 50 of whom were shown to have myocardial infarction. Urine cotinine/creatinine (cot/creat) ratio measured within 4 hours of admission was used as an objective marker of cigarette smoking in the preceding 18 hours. Fifty-seven patients had urine cot/creat ratios suggesting recent smoking, although four of these denied smoking. Patients with myocardial infarction had higher median cot/creat ratios (3.31 jig/mg, range 0-17.8) compared with patients with non-infarct chest pain (0.5 rg/mg, range 0-37.2). Sixteen patients with cardiac rhythm disturbances following infarction had significantly higher cot/creat ratios than the 34 infarct patients without this complication (median and range 8.34 JAg/mg; 0-17.8 V.

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Objective: To investigate rates of inappropriate shocks in patients with a Medtronic Protecta implantable cardioverter defibrillator device (Medtronic Inc., Minneapolis, MN, USA). Methods:Consecutive patients implanted with Protecta defibrillators at a single centre between April 2010 and July 2012 were studied retrospectively.Results: Follow-up data was available for 599 patients(84% male; age 64 ± 14 years, range 16-92; 49% secondary prevention indication; 42% cardiac resynchronisation therapy, 24% single chamber, and 34% dual chamber defibrillator devices). Mean follow-up was 19 ± 7 months. 57 patients (9.5%) received a shock: 8 patients(1.3%) had inappropriate shocks; 50 patients(8.3%) had appropriate shocks. Of the 10 inappropriate shocks, seven were for supraventricular tachycardia; one for T-wave oversensing; one due to lead displacement; and one occurred after an appropriate shock for ventricular tachycardia. Conclusions:Our reported inappropriate shock rate over a 20-month follow-up period is lower than previously reported.

TX 75083-3836, U.S.A., fax 01-972-952-9435. AbstractZubair and Upper Burgan are important clastic reservoirs in North Kuwait. Phase 1 of the North Kuwait Waterflood Project includes peripheral water injection for pressure maintenance of these reservoirs. Injection at matrix conditions commenced in mid 2001 and though initial injection rates were promising, injectivity declined rapidly in many wells. Various remedial actions were unsuccessful in achieving sustained injection at desired rates. Subsequently, a series ofStep Rate Tests were conducted which indicated that desired injectivity could be achieved if injection was above fracture conditions. Consequently, measurement of fracture pressures for the reservoirs assumed key importance for forward planning and design of injection facilities for Phase 2 of the Waterflood Project.

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