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The energy shift of K electrons in heavy atoms due to the self-energy correction has been calculated. This process is treated to all orders in Zα, where Z denotes the nuclear charge. For the superheavy system Z=170, where the K-shell binding energy reaches the pair-production threshold (E1sb∼2mc2), a shift of +11.0 keV is found. This shift is almost cancelled by the vacuum polarization, leaving a negligible effect for all quantum-electrodynamical corrections of order α but all orders of Zα.
Conversion processes in light nuclei with transition energies above the e+, e- pair creation threshold are investigated within an analytical framework. In particular, we evaluate the ratio of electron transition probabilities from the negative energy continuum into the atomic K shell and into the positive energy continuum, respectively. The possible role of monoenergetic positron conversion with respect to the striking peak structures observed in e+ spectra from very heavy collision systems is examined.
The angular distribution of electrons and positrons emitted in internal pair conversion is calculated. Coulomb-distorted waves are used as electron wave functions. Nuclear transitions of various multipolarities L>0 and of magnetic (ML) and of electric (EL) type are considered as well as E0 conversion. Analytical expressions for the angular correlation are derived, which are evaluated numerically assuming a finite extension of the nucleus and, for the EL and ML conversion, also in the point-nucleus approximation. The calculated angular correlations are compared with results obtained within the Born approximation and, for the E0 case, with experimental data.
A method is presented to define unique continuum states for the two-center Dirac Hamiltonian. In the spherical limit these states become the familiar angular-momentum eigenstates of the radial Coulomb potential. The different states for a fixed total energy ‖E‖>m may be distinguished by considering the asymptotic spin-angular distribution of states with unique scattering phases. The first numerical solutions of the two-center Dirac equation for continuum states are presented.
Aims: The primary safety and efficacy endpoints of the randomized FIRE AND ICE trial have recently demonstrated non-inferiority of cryoballoon vs. radiofrequency current (RFC) catheter ablation in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (AF). The aim of the current study was to assess outcome parameters that are important for the daily clinical management of patients using key secondary analyses. Specifically, reinterventions, rehospitalizations, and quality-of-life were examined in this randomized trial of cryoballoon vs. RFC catheter ablation.
Methods and results: Patients (374 subjects in the cryoballoon group and 376 subjects in the RFC group) were evaluated in the modified intention-to-treat cohort. After the index ablation, log-rank testing over 1000 days of follow-up demonstrated that there were statistically significant differences in favour of cryoballoon ablation with respect to repeat ablations (11.8% cryoballoon vs. 17.6% RFC; P = 0.03), direct-current cardioversions (3.2% cryoballoon vs. 6.4% RFC; P = 0.04), all-cause rehospitalizations (32.6% cryoballoon vs. 41.5% RFC; P = 0.01), and cardiovascular rehospitalizations (23.8% cryoballoon vs. 35.9% RFC; P < 0.01). There were no statistical differences between groups in the quality-of-life surveys (both mental and physical) as measured by the Short Form-12 health survey and the EuroQol five-dimension questionnaire. There was an improvement in both mental and physical quality-of-life in all patients that began at 6 months after the index ablation and was maintained throughout the 30 months of follow-up.
Conclusion: Patients treated with cryoballoon as opposed to RFC ablation had significantly fewer repeat ablations, direct-current cardioversions, all-cause rehospitalizations, and cardiovascular rehospitalizations during follow-up. Both patient groups improved in quality-of-life scores after AF ablation.
Clinical trial registration: ClinicalTrials.gov identifier: NCT01490814.
The FIRE AND ICE Trial (ClinicalTrials.gov, identifier NCT01490814) was initiated in 2012 as a multicenter, randomized, head‐to‐head comparison of radiofrequency current (RFC) and cryoballoon catheter ablation for the treatment of patients with drug‐refractory symptomatic paroxysmal atrial fibrillation (AF). Six years on, it remains the largest, randomized comparison of safety and efficacy between 2 catheter ablation modalities used in the treatment of patients with AF. This landmark trial not only established noninferiority between cryoballoon and RFC ablation for pulmonary vein isolation (PVI) with regard to the study's efficacy and safety primary end points,1 but also, it evaluated secondary end points that were critical for a representative study interpretation. ...
