Search Our Scientific Publications & Authors

JAMA Cardiol 2020 Jun 3. Epub 2020 Jun 3.

Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.

Int J Cardiol Heart Vasc 2020 Jun 26;28:100543. Epub 2020 May 26.

Internal Medicine, Division of Cardiology, Columbia University Irving Medical Center, 622 W 168th St, New York, NY 10032, USA.

Background: Patients with Tetralogy of Fallot (TOF) are at increased risk for sudden cardiac death, often undergo implantable cardioverter defibrillator (ICD) implantation at younger ages, and are at greater risk of experiencing inappropriate shocks. We investigated occurrences of ICD shocks in TOF patients to identify prevalence, characteristics associated with inappropriate shocks, and therapeutic interventions after inappropriate shocks.

Methods: Records of patients with repaired TOF and ICD implantation who were followed at Columbia University Irving Medical Center between 1/1/2000 and 5/1/2019 were analyzed. Read More

Ther Adv Endocrinol Metab 2020 19;11:2042018820911803. Epub 2020 May 19.

Steno Diabetes Centre Copenhagen, Gentofte Hospital, Kildegårdsvej 28, Hellerup, 2900, Denmark.

Hypoglycaemia remains an inevitable risk in insulin-treated type 1 diabetes and type 2 diabetes and has been associated with multiple adverse outcomes. Whether hypoglycaemia is a cause of fatal cardiac arrhythmias in diabetes, or merely a marker of vulnerability, is still unknown. Since a pivotal report in 1991, hypoglycaemia has been suspected to induce cardiac arrhythmias in patients with type 1 diabetes, the so-called 'dead-in-bed syndrome'. Read More

Indian J Anaesth 2020 Apr 28;64(4):339-341. Epub 2020 Mar 28.

Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India.

J Muscle Res Cell Motil 2020 Jun 2. Epub 2020 Jun 2.

Molecular Medicine Section, Department of Molecular and Developmental Medicine, University of Siena, Via A. Moro, 2, 53100, Siena, Italy.

Calsequestrin (CASQ) is the most abundant Ca binding protein localized in the sarcoplasmic reticulum (SR) of skeletal and cardiac muscle. The genome of vertebrates contains two genes, CASQ1 and CASQ2. CASQ1 and CASQ2 have a high level of homology, but show specific patterns of expression. Read More

Am Heart J 2020 May 3;225:129-137. Epub 2020 May 3.

Division of Cardiovascular Medicine, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA; Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA. Electronic address:

Introduction: Retrospective studies have shown conflicting benefit of utilizing targeted temperature management (TTM) in cardiac arrest (CA) patients with a non-shockable rhythm and presently there is only one randomized trial in this realm. We sought to determine trends and outcomes of TTM utilization in these patients from a large nationally representative United States population database.

Methods And Results: Data were derived from National Inpatient Sample (NIS) from January 2006 to December 2013. Read More

Circ Cardiovasc Imaging 2020 Jun;13(6):e010084

Division of Cardiology (K.B.-J., N.B.M., D.R., S.N., I.A.E., D.K., R.W.S., S.K.P.), Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston.

Medicine (Baltimore) 2020 May;99(21):e19970

Department of Cardiology, Poznań University of Medical Sciences.

Introduction: The RF ablation of ventricular tachycardia (VT) or atrial flutter (AFl) can be unsuccessful due to lack of lesion transmurality. Bipolar ablation (BA) is more successful than unipolar ablation (UA). The purpose of our study was to investigate the long-term effect of BA ablation in patients after failed UA. Read More

J Innov Card Rhythm Manag 2018 Jun 15;9(6):3212-3213. Epub 2018 Jun 15.

UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

J Innov Card Rhythm Manag 2018 Feb 15;9(2):3022-3024. Epub 2018 Feb 15.

Division of Cardiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

J Innov Card Rhythm Manag 2018 Sep 15;9(9):3336-3337. Epub 2018 Sep 15.

UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

J Innov Card Rhythm Manag 2018 Sep 15;9(9):3324-3326. Epub 2018 Sep 15.

Heart Rhythm Center at Monzino Cardiac Centre, IRCCS, Milan, Italy.

J Innov Card Rhythm Manag 2018 Sep 15;9(9):3297-3302. Epub 2018 Sep 15.

Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.

Inherited ion channelopathies have come to the forefront as a significant cause of sudden cardiac death (SCD) in pediatric patients with structurally normal hearts. Implantable cardioverter-defibrillator (ICD) placement can be a life-saving primary preventative therapy, but because of actors inherent in the pediatric population, careful thought must be given to the specific indications for placement in each patient. The most common inherited ion channelopathies are long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Read More

J Innov Card Rhythm Manag 2018 Jun 15;9(6):3183-3184. Epub 2018 Jun 15.

Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, ON, Canada.

A coring technique is an effective strategy to overcome short linear segmental chronic occlusions in subclavian veins caused by previously implanted leads. We present the case of an 82-year-old male who was transferred from a primary care center for consideration for implantable cardioverter-defibrillator placement following an episode of sustained monomorphic ventricular tachycardia and hemodynamic compromise that required direct-current cardioversion. A coring technique was successfully used in this patient. Read More

J Innov Card Rhythm Manag 2018 May 15;9(5):3151-3162. Epub 2018 May 15.

Department of Pharmacy Practice, University of Connecticut, Storrs, CT, USA.

Wearable cardioverter-defibrillators (WCDs) protect patients from sudden cardiac death (SCD) by detecting and treating life-threatening ventricular tachycardia/fibrillation (VT/VF). Recently, two large studies evaluating WCDs were published. However, the results of older and newer studies have yet to be systematically summarized. Read More

J Innov Card Rhythm Manag 2018 Mar 15;9(3):3059-3061. Epub 2018 Mar 15.

Electrophysiology Section, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA, USA.

A wide complex tachycardia (WCT) that presents in a patient with a history of coronary artery disease and myocardial infarction is most likely ventricular in origin. We discuss a case of WCT due to a variant of pre-excitation in such a patient. Read More

J Innov Card Rhythm Manag 2018 Feb 15;9(2):3035-3049. Epub 2018 Feb 15.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Despite advances in the diagnosis and treatment of acute coronary syndromes and an overall improvement in outcomes, mortality after myocardial infarction (MI) remains high. Sudden death, which is most frequently due to ventricular tachycardia or ventricular fibrillation, is the cause of death in 25% to 50% of patients with prior MI, and therefore represents an important public health problem. Use of the implantable cardioverter-defibrillator (ICD), which is the primary method of reducing the chance of arrhythmic sudden death after MI, is costly to the medical system and is associated with procedural and long-term risks. Read More

J Innov Card Rhythm Manag 2018 Feb 15;9(2):3016-3021. Epub 2018 Feb 15.

Division of Cardiology, Virginia Commonwealth University Pauley Heart Center, Richmond, VA, USA.

Cardiac sarcoidosis (CS) can cause atrial and ventricular arrhythmias, conduction system disease, and congestive heart failure. The use of advanced imaging modalities including cardiac magnetic resonance and positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose can be helpful in evaluating the extent of disease and response to treatment. The management of CS patients can be challenging, requiring immunosuppression medications, antiarrhythmic drugs, implantable cardiac devices, and cardiac ablation procedures. Read More

J Innov Card Rhythm Manag 2018 Dec 15;9(12):3440-3445. Epub 2018 Dec 15.

Department of Cardiology, Northwestern Memorial Hospital, Chicago, IL, USA.

In this review, we examine the current state of gene therapy for the treatment of cardiac arrhythmias. We describe advances and challenges in successfully creating and incorporating gene vectors into the myocardium. After summarizing the current scientific research in gene transfer technology, we then focus on the most promising areas of gene therapy at this time, which is the treatment of atrial fibrillation and ventricular tachyarrhythmias. Read More

J Innov Card Rhythm Manag 2018 Oct 15;9(10):3338-3353. Epub 2018 Oct 15.

Department of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Ventricular arrhythmias (VAs) are among the most common cardiac rhythm disturbances encountered in clinical practice. Patients presenting with frequent ventricular ectopy or sustained ventricular tachycardia represent a challenging and worrisome clinical scenario for many practitioners because of concerning symptoms, frequent associated acute hemodynamic compromise, and the adverse prognostic implications inherent to these cases. While an underlying structural or functional cardiac abnormality, metabolic derangement, or medication toxicity is often readily apparent, many patients have no obvious underlying condition, despite a comprehensive diagnostic evaluation. Read More

J Innov Card Rhythm Manag 2018 Jan 15;9(1):2969-2981. Epub 2018 Jan 15.

Cardiac Electrophysiology Section, University of California, San Francisco, San Francisco, CA, USA.

Ventricular arrhythmias arise from complex electroanatomical substrates in patients with structural heart disease. There have been significant advancements in technologies and techniques for ventricular tachycardia catheter ablation. A systematic approach to mapping and ablation is paramount, and catheter ablation has shifted to be a potential first-line therapy for patients needing early intervention, particularly for those with post-infarction arrhythmias. Read More

J Innov Card Rhythm Manag 2017 Feb 15;8(2):2626-2627. Epub 2017 Feb 15.

Icahn School of Medicine at Mount Sinai, New York, NY.

A wide-complex tachycardia was induced with rapid atrial pacing, with intermittent ventriculoatrial block and QRS alternans. A short/negative HV interval was observed, and premature ventricular complexes resulted in the termination of the tachycardia. The findings at electrophysiology study were consistent with an antidromic re-entrant tachycardia involving a nodo-fascicular/ventricular connection. Read More

J Innov Card Rhythm Manag 2017 Oct 15;8(10):2853-2861. Epub 2017 Oct 15.

Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA.

Electrical storm (ES) is an increasingly common medical emergency characterized by clustered episodes of sustained ventricular arrhythmias (VAs) that lead to repeated appropriate implantable cardioverter-defibrillator (ICD) therapies. A diagnosis of ES can be made with the occurrence of three or more sustained episodes of VAs, or of three or more appropriate ICD therapies within 24 hours in patients with implanted devices. ES is associated with poor outcomes in patients with structural heart disease, particularly those with severe left ventricular dysfunction. Read More

J Innov Card Rhythm Manag 2017 Jan 15;8(1):2590-2593. Epub 2017 Jan 15.

The Arrhythmia Center at the Charlotte Heart and Vascular Institute, Port Charlotte, FL.

A 62-year-old gentleman with a history of an ischemic cardiomyopathy and previous implantation of a biventricular cardioverter-defibrillator presented with complaints of palpitations and a wide complex ventricular paced rhythm at 120 bpm. This was originally thought to be ventricular tracking of an atrial tachycardia at the upper tracking rate, as the patient remained hemodynamically stable for three consecutive days in this rhythm. On the third day, the patient's implantable cardioverter-defibrillator (ICD) was interrogated and it was found that he was indeed in a sustained ventricular tachycardia with biventricular pacing being delivered as a function of the ventricular sense response feature. Read More

J Innov Card Rhythm Manag 2019 Apr 15;10(4):3617-3619. Epub 2019 Apr 15.

Abbott Laboratories, Chicago, IL, USA.

Intact retrograde ventriculoatrial (VA) conduction in the presence of complete atrioventricular (AV) heart block has been well-documented in the past. We sought to describe the prevalence and clinical significance of intact VA conduction accompanied by complete antegrade AV block in patients with implanted cardiac rhythm management (CRM) devices. During routine follow-up of CRM devices in our device clinic, 42 patients were found to be in a state of complete heart block. Read More

J Innov Card Rhythm Manag 2019 Mar 15;10(3):3565-3580. Epub 2019 Mar 15.

IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.

Catheter ablation for ventricular tachycardia (VT) has been increasingly used over the past two decades in patients with structural heart disease (SHD). In these individuals, a substrate mapping strategy is being more commonly applied to identify targets for VT ablation, which has been shown to be more effective versus targeting mappable VTs alone. There are a number of substrate mapping methods in existence that aim to explore potential VT isthmuses, although their success rates vary. Read More

Heart Rhythm 2020 May 29. Epub 2020 May 29.

School of Physics, Georgia Institute of Technology, Georgia, USA. Electronic address:

Background: Early during the current COVID-19 pandemic, hydroxychloroquine (HCQ) received a significant amount of attention as a potential antiviral treatment, such that it became one of the most commonly prescribed medications for COVID-19 patients. However, not only the effectiveness of HCQ has remained questionable, and mainly based on pre-clinical, and a few small clinical studies, but also HCQ is known to be potentially arrhythmogenic, especially as a result of QT prolongation.

Objective: To investigate the arrhythmic effects of HCQ as the heightened risk is especially relevant as COVID-19 patients are at a higher risk of cardiac complications and arrhythmias at baseline. Read More

J Cardiovasc Electrophysiol 2020 Jun 1. Epub 2020 Jun 1.

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

Background: The pathologic process of ARVC (arrhythmogenic right ventricular cardiomyopathy) typically originates in the epicardium or subepicardial layers with progression towards endocardium. However, in the most recent ARVC international task force consensus statement, epicardial ventricular tachycardia (VT) ablation is recommended as a Class I indication only in patients with at least one failed endocardial VT ablation attempt.

Objective: The aim of this meta-analysis is to assess the outcomes of ARVC patients undergoing combined endo-epicardial VT ablation, as compared to endocardial ablation alone. Read More

J Innov Card Rhythm Manag 2019 Sep 15;10(9):3815-3821. Epub 2019 Sep 15.

Abbott Laboratories, Sylmar, CA, USA.

The association between ventricular arrhythmia (VA) burden or defibrillator therapy and pulmonary artery pressure (PAP) has not been characterized in an ambulatory setting; thus, we sought in the present research to determine the relationship between ambulatory PAP and VA burden. A retrospective cohort study involving patients with an implantable cardiac defibrillator and CardioMEMS™ PAP sensor (Abbott Laboratories, Chicago, IL, USA) both transmitting remotely into the Merlin.net™ patient care network (Abbott Laboratories, Chicago, IL, USA) was conducted. Read More

J Innov Card Rhythm Manag 2019 Aug 15;10(8):3762-3773. Epub 2019 Aug 15.

Cardiac Electrophysiology Department, Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.

Patients with structural heart disease (SHD) are at risk of ventricular tachycardia (VT), which can be difficult to manage clinically. Many treatment options are currently available, but no single approach can be applied with 100% perfect results; often, a combination of therapies is required to achieve good control of ventricular arrhythmias. Coronary artery disease with previous myocardial infarction (MI) is the most common form of SHD presenting with VT, with scar-mediated reentry being the predominant mechanism. Read More

J Innov Card Rhythm Manag 2019 Jul 15;10(7):3719-3721. Epub 2019 Jul 15.

Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Health Sciences University, Ankara, Turkey.

Mechanical prosthetic aortic and mitral valves preclude either a retrograde aortic or transseptal approach to the left ventricular (LV) endocardium. Several operators have reported on the application of nonconventional techniques for ventricular tachycardia (VT) ablation including transventricular septal puncture, epicardial approach, transmechanical valve approach, transcoronary venous approach, and transapical approach. Incorporating transventricular access to the LV under intracardiac echocardiography (ICE) guidance has been previously attempted in VT ablation procedures in patients with both aortic and mitral mechanical valves. Read More

J Innov Card Rhythm Manag 2019 Jun 15;10(6):3707-3715. Epub 2019 Jun 15.

Atrial Fibrillation and Complex Arrhythmia Center, California Pacific Medical Center, San Francisco, CA, USA.

Scar-mediated ventricular tachycardia (VT) is a recognized cause of morbidity and mortality in patients with ischemic cardiomyopathy and other cardiomyopathies such as nonischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and cardiac sarcoidosis. Implantable cardioverter-defibrillator (ICD) therapy improves survival but does not prevent the onset of recurrent VT or associated morbidity from ICD shocks. While randomized controlled trials have demonstrated advantages of scar-mediated VT ablation in comparison with antiarrhythmic drugs, procedural success has remained overall modest at between 50% and 70%. Read More

J Innov Card Rhythm Manag 2019 May 15;10(5):3652-3661. Epub 2019 May 15.

Section of Electrophysiology & Pacing, Division of Cardiology, Department of Medicine, Baylor Scott & White Temple Memorial Hospital, Baylor Scott & White Health, Dallas, TX, USA.

Temporary cardiac pacing is commonly used in patients with life-threatening bradycardia and serves as a bridge to implantation of a permanent pacemaker (PPM). For years, passive fixation leads have been used for this purpose, offering the advantage of that they can be placed at bedside. The downside, however, is that patients must remain on telemetry and bed rest until lead removal due to the risk of displacement and failure to capture. Read More

J Innov Card Rhythm Manag 2019 Nov 15;10(11):3913-3918. Epub 2019 Nov 15.

Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

In this complex case study, we discuss a patient who underwent successful catheter ablation for ventricular tachycardia following left ventricular assist device placement. We discuss the technique and review existing literature in an effort to explore the feasibility and safety of this procedure in this clinical setting. Read More

J Innov Card Rhythm Manag 2019 Nov 15;10(11):3897-3905. Epub 2019 Nov 15.

Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado Denver, Aurora, CO, USA.

Epicardial catheter ablation is most commonly performed following unsuccessful endocardial ablation. Given the frequency of epicardial substrates in certain cardiomyopathic disease states, however, a combined endocardial-epicardial approach should be considered as a primary treatment strategy. Although epicardial ablation is primarily deployed in patients with ventricular arrhythmias, the role of epicardial approaches in supraventricular tachycardias (eg, atrial fibrillation, inappropriate sinus tachycardia, and-rarely-accessory pathways) is growing, with continued advances being made. Read More

J Innov Card Rhythm Manag 2019 Oct 15;10(10):3860-3864. Epub 2019 Oct 15.

Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA.

This is a report of a patient with a history of hypertension and myocardial infarction and a left ventricular ejection fraction of 35% who suffered a syncopal event. Her admitting electrocardiogram was compatible with her old myocardial infarction, an anteroseptal left ventricular aneurysm, left ventricular hypertrophy, and short-QT syndrome. The present report discusses how each of these might contribute individually and to some extent synergistically to producing syncope. Read More

Rev Bras Anestesiol 2020 May 13. Epub 2020 May 13.

Meikai University School of Dentistry, Department of Diagnostic and Therapeutic Sciences, First Division of Oral and Maxillofacial Surgery, Sakado-Shi, Japan.

Background And Objectives: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic cardiomyopathy characterized by potentially lethal ventricular tachycardia. Here we describe a patient with ARVC and an Implantable Cardioverter Defibrillator (ICD) in whom maxillary sinus surgery was performed under general anesthesia.

Case Report: The patient was a 59 year-old man who was scheduled to undergo maxillary sinus surgery under general anesthesia. Read More

Heart Rhythm 2020 May 26. Epub 2020 May 26.

Division of Cardiac Electrophysiology, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, Texas,. Electronic address:

Background: Venous ethanol infusion via an occlusive balloon has been utilized as bail-out approach to treat ablation-refractory ventricular arrhythmias (VA). Unfavorable venous anatomy - lack of intramural veins at the targeted site or collateral vein-ethanol shunting- limits its efficacy. Blocking collateral flow with a second balloon may optimize myocardial ethanol delivery. Read More

Arch Argent Pediatr 2020 Jun;118(3):e284-e287

Department of Pediatric Cardiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ziraat Mah, Ankara, Turkey.

Myocarditis is a serious complication of varicella zoster virus infection. A 15 year-old boy was admitted to the Emergency Department for chest pain, tachycardia and hypotension. An electrocardiogram showed sinus tachyicardia. Read More

Pacing Clin Electrophysiol 2020 May 29. Epub 2020 May 29.

Cardiology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Background: Anti-tachycardia pacing (ATP), which may avoid unnecessary ICD shocks, does not always terminate ventricular arrhythmias (VAs). Mean entropy calculated using cardiac magnetic resonance texture analysis (CMR-TA) has been shown to predict appropriate ICD therapy. We examined whether scar heterogeneity, quantified by mean entropy, is associated with ATP failure and explore potential mechanisms using computer modelling. Read More

J Am Heart Assoc 2020 Jun 29;9(11):e015119. Epub 2020 May 29.

Dorothy M. Davis Heart and Lung Research Institute College of Medicine The Ohio State University Wexner Medical Center Columbus OH.

Background Atrial fibrillation (AF) is a comorbidity associated with heart failure and catecholaminergic polymorphic ventricular tachycardia. Despite the Ca-dependent nature of both of these pathologies, AF often responds to Na channel blockers. We investigated how targeting interdependent Na/Ca dysregulation might prevent focal activity and control AF. Read More

Herzschrittmacherther Elektrophysiol 2020 May 28. Epub 2020 May 28.

Klinik für Innere Medizin - Kardiologie, Diabetologie & Nephrologie, Evangelisches Klinikum Bethel, Burgsteig 13, 33617, Bielefeld, Germany.

Follow-up of pacemaker systems for His bundle pacing (HBP) requires electrocardiogram (ECG) knowledge and creative thinking. This relates to ventricular threshold measurement in which it can be difficult to distinguish between selective HBP and loss of capture with pseudofusion since, by definition, intrinsic QRS complexes and those selectively paced via the His bundle look identical. Threshold testing in HBP is best performed in unipolar pacing mode, recording of a 12-lead ECG and pacing in VVI mode significantly above the intrinsic rate. Read More

Cureus 2020 Apr 25;12(4):e7824. Epub 2020 Apr 25.

Cardiology, Rhode Island University Hospital - Warren Alpert Medical School of Brown University, Rhode Island, USA.

Introduction Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) are frequently associated with atrial fibrillation (AF). Targeting the slow or accessory pathways has been advocated as therapy for coexisting AF. But in practice, AF has frequently recurred after ablation, possibly because of various risk factors. Read More

J Am Coll Cardiol 2020 Jun;75(21):2698-2707

Greenlane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Cardiac Inherited Disease Group, Auckland, New Zealand; Department of Paediatrics Child and Youth Health, University of Auckland, Auckland, New Zealand. Electronic address:

Background: The relative proportion of each cardiac inherited disease (CID) causing resuscitated sudden cardiac arrest (RSCA) on a population basis is unknown.

Objectives: This study describes the profile of patients with CIDs presenting with RSCA; their data were collected by the national Cardiac Inherited Diseases Registry New Zealand (CIDRNZ).

Methods: Data were collated from CIDRNZ probands presenting with RSCA (2002 to 2018). Read More