Money is a great motivator, once again: A financial incentive offered to doctors and nurses who successfully convinced patients to quit smoking resulted in doubling the number of patients who dropped the tobacco habit, according to a new USC study.

The results were reported last week at the American Heart Association meeting in Orlando, Florida.

There, USC Institute for Prevention Research scientist James Dwyer and colleagues detailed their findings of how monetary rewards - for health care workers - can help encourage healthy habits.

In talks and poster sessions, the meeting featured new research by some 40 Health Sciences Campus scientists, who joined 23,000 other medical professionals interested in the basic research and clinical treatment of heart and blood vessel diseases.

Smoking leaves people at high risk for cardiovascular disease, but quitting is tough.

In hopes of preventing such disease, Dwyer studied employees at a large utility company, half of whom used the company primary care clinic for health care.

After figuring out how much money the company would save if their employees stopped smoking, the company and the USC team offered a percentage of these savings, some $240 a year, to company medical staff for each patient that gives up smoking within six months of visiting the clinic.

When Dwyer compared the smoking cessation rate of employees who used the company clinic with a control group that used an outside HMO, he found that the financial incentive doubled the smoking cessation rate at the company clinic, even after taking into account other factors such as years of regular smoking and percentage of friends who smoke.

"This is a pilot study to see whether it works to link a physician's remuneration to the success of their practice - in this case smoking cessation. But you could also look at something like detection and control of diabetes," Dwyer said.

"Our results are suggestive that such a system might work, but whether it will work in the real world is still open to question," he said.

USC cardiologists also had big presence at the meeting:

Cardiologist David Kawanishi, an associate professor of medicine, presented a study on the risks associated with a pacemaker that has been officially recalled by the company that makes it.

Worldwide, some 40,000 of the Accufix atrial pacemakers have been implanted into patients. The Accufix uses a J-shaped wire to speed up patients' slow heart rates. Frequent breaks in the pacemaker's wire led to a handful of deaths, which prompted the recall and, in turn, led a huge number of patients to undergo surgery to remove the units. In just six months, more than 2,000 Accufix pacemakers were removed.

But Kawanishi, who sits on a committee formed to advise the company about the recall effort and safety of the pacemakers, has noticed a disturbing trend-while physicians know of a total of six people who have died so far due to complications of the Accufix pacemaker, 14 have died following surgery to remove the questionable heart device.

"The danger in taking it out is that scar tissue can form in the heart, which may cause serious problems," Kawanishi said.

His most recent study showed that for patients whose pacemaker J-wire is already starting to fray, nine in a hundred patients will go on to have a more serious problem.

These people "should strongly consider taking it out," said Kawanishi. On the other hand, only four patients in a hundred will develop a new break in the J-wire, a number which Kawanishi thinks may tip the scales in the other direction for these patients.

Deciding whether to remove the J-wire or not "is very a difficult decision," Kawanishi said, but hopes his newest study will assist doctors and their patients in better weighing the risks.

Elsewhere at the meeting: Uri Elkayam, cardiologist and professor of medicine, offered insights into how to manage the increasing number of patients with adult congenital heart disease.

P. Anthony Chandraratna, professor of medicine and associate chief of cardiology, presented results from his work on the diagnostic use of ultrasound and transthoracic echocardiography in patients with heart disease.

Other USC research highlighted at the meeting included a report on the largest hypertension study ever undertaken, on which School of Medicine cardiologist Vincent DeQuattro serves as a co-investigator.

Ongoing, the study of 25,000 people is designed to find out if some blood pressure medicines reduce the rate of cardiac morbidity and death better than others, independent of their ability to reduce blood pressure.