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Clark BC, Olen M, Dechert B, Brateng C, Jarosz B, Smoots K, Connell P, Dupanovic ST, Fenrich A, Hill AC, LaPage M, Mah D, McCanta A, Malloy-Walton L, Pflaumer A, Radbill A, Tanel R, Whitehill R, Dalal A. Current State of Cardiac Implantable Electronic Device Remote Monitoring in Pediatrics and Congenital Heart Disease: A PACES-Sponsored Quality Improvement Initiative. Pediatr Cardiol 2024; 45:114-120. [PMID: 38036754 DOI: 10.1007/s00246-023-03348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023]
Abstract
Cardiac implantable electronic device (CIED) remote transmissions are an integral part of longitudinal follow-up in pediatric and adult congenital heart disease (ACHD) patients. To evaluate baseline CIED remote monitoring (RM) data among pediatric and ACHD centers prior to implementation of a Pediatric and Congenital Electrophysiology Society (PACES)-sponsored quality improvement (QI) project. This is a cross-sectional study of baseline CIED RM. Centers self-reported baseline data: individual center RM compliance was defined as high if there was > 80% achievement and low if < 50%. A total of 22 pediatric centers in the USA and Australia submitted baseline data. Non-physicians were responsible for management of the RM program in most centers: registered nurse (36%), advanced practice provider (27%), combination (23%), and third party (9%). Fifteen centers (68%) reported that > 80% of their CIED patients are enrolled in RM and only two centers reported < 50% participation. 36% reported high compliance of device transmission within 14 days of implant and 77% of centers reported high compliance of CIED patients enrolled in RM. The number of centers achieving high compliance differed by device type: 36% for pacemakers, 50% for ICDs, and 55% for Implantable Cardiac Monitors (ICM). All centers reported at least 50% adherence to recommended follow-up for PM and ICD, with 23% low compliance rate for ICMs. Based on this cross-sectional survey of pediatric and ACHD centers, compliance with CIED RM is sub-optimal. The PACES-sponsored QI initiative will provide resources and support to participating centers and repeat data will be evaluated after PDSA cycles.
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Mondal A, Yoo M, Tuttle S, Mah D, Nelson R, Sachse FB, Hitchcock R, Kaza AK. Cost of Pacing in Pediatric Patients With Postoperative Heart Block After Congenital Heart Surgery. JAMA Netw Open 2023; 6:e2341174. [PMID: 37921766 PMCID: PMC10625035 DOI: 10.1001/jamanetworkopen.2023.41174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023] Open
Abstract
Importance Surgical correction of congenital heart defects (CHDs) has improved the lifespan and quality of life of pediatric patients. The number of congenital heart surgeries (CHSs) in children has grown continuously since the 1960s. This growth has been accompanied by a rise in the incidence of postoperative heart block requiring permanent pacemaker (PPM) implantation. Objective To assess the trends in permanent pacing after CHS and estimate the economic burden to patients and their families after PPM implantation. Design, Setting, and Participants In this economic evaluation study, procedure- and diagnosis-specific codes within a single-institution database were used to identify patients with postoperative heart block after CHS between January 1, 1960, and December 31, 2018. Patients younger than 4 years with postoperative PPM implantation were selected, and up to 20-year follow-up data were used for cost analysis based on mean hospital event charges and length of stay (LOS) data. Data were analyzed from January 1, 2020, to November 30, 2022. Exposure Implantation of PPM after CHS in pediatric patients. Main Outcomes and Measures Annual trends in CHS and postoperative PPM implantations were assessed. Direct and indirect costs associated with managing conduction health for the 20 years after PPM implantation were estimated using Markov model simulation and patient follow-up data. Results Of the 28 225 patients who underwent CHS, 968 (437 female [45.1%] and 531 male [54.9%]; 468 patients aged <4 years) received a PPM due to postoperative heart block. The rate of CHS and postoperative PPM implantations increased by 2.2% and 7.2% per year between 1960 and 2018, respectively. In pediatric patients younger than 4 years with PPM implantation, the mean (SD) 20-year estimated direct and indirect costs from Markov model simulations were $180 664 ($32 662) and $15 939 ($1916), respectively. Using follow-up data of selected patients with clinical courses involving 1 or more complication events, the mean (SD) direct and indirect costs were $472 774 ($212 095) and $36 429 ($16 706), respectively. Conclusions and Relevance In this economic evaluation study, the cost of PPM implantation in pediatric patients was found to accumulate over the lifespan. This cost may represent not only a substantial financial burden but also a health care burden to patient families. Reducing the incidence of PPM implantation should be a focused goal of CHS.
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Rogatinsky J, Recco D, Feichtmeier J, Kang Y, Kneier N, Hammer P, O’Leary E, Mah D, Hoganson D, Vasilyev NV, Ranzani T. A multifunctional soft robot for cardiac interventions. SCIENCE ADVANCES 2023; 9:eadi5559. [PMID: 37878705 PMCID: PMC10599628 DOI: 10.1126/sciadv.adi5559] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023]
Abstract
In minimally invasive endovascular procedures, surgeons rely on catheters with low dexterity and high aspect ratios to reach an anatomical target. However, the environment inside the beating heart presents a combination of challenges unique to few anatomic locations, making it difficult for interventional tools to maneuver dexterously and apply substantial forces on an intracardiac target. We demonstrate a millimeter-scale soft robotic platform that can deploy and self-stabilize at the entrance to the heart, and guide existing interventional tools toward a target site. In two exemplar intracardiac procedures within the right atrium, the robotic platform provides enough dexterity to reach multiple anatomical targets, enough stability to maintain constant contact on motile targets, and enough mechanical leverage to generate newton-level forces. Because the device addresses ongoing challenges in minimally invasive intracardiac intervention, it may enable the further development of catheter-based interventions.
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Chubb H, Mah D, Dubin AM, Moore J. Conduction system pacing in pediatric and congenital heart disease. Front Physiol 2023; 14:1154629. [PMID: 37035676 PMCID: PMC10080025 DOI: 10.3389/fphys.2023.1154629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/15/2023] [Indexed: 04/11/2023] Open
Abstract
Conduction system pacing (CSP) has evolved rapidly to become the pacing method of choice for many adults with structurally normal hearts. Studies in this population have repeatedly demonstrated superior hemodynamics and outcomes compared to conventional pacing with the recruitment of the native conduction system. Children and patients with congenital heart disease (CHD) are also likely to benefit from CSP but were excluded from original trials. However, very recent studies have begun to demonstrate the feasibility and efficacy of CSP in these patients, with growing evidence that some outcomes may be superior in comparison to conventional pacing techniques. Concerns regarding the technical challenges and long-term lead parameters of His Bundle Pacing (HBP) have been overcome to many extents with the development of Left Bundle Branch Area Pacing (LBBAP), and both techniques are likely to play an important role in pediatric and CHD pacing in the future. This review aims to assimilate the latest developments in CSP and its application in children and CHD patients.
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Chubb H, Bulic A, Mah D, Moore JP, Janousek J, Fumanelli J, Asaki SY, Pflaumer A, Hill AC, Escudero C, Kwok SY, Mangat J, Ochoa Nunez LA, Balaji S, Rosenthal E, Regan W, Horndasch M, Asakai H, Tanel R, Czosek RJ, Young ML, Bradley DJ, Paul T, Fischbach P, Malloy-Walton L, McElhinney DB, Dubin AM. Impact and Modifiers of Ventricular Pacing in Patients With Single Ventricle Circulation. J Am Coll Cardiol 2022; 80:902-914. [PMID: 36007989 DOI: 10.1016/j.jacc.2022.05.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/04/2022] [Accepted: 05/23/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Palliation of the single ventricle (SV) circulation is associated with a burden of lifelong complications. Previous studies have identified that the need for a permanent ventricular pacing system (PPMv) may be associated with additional adverse long-term outcomes. OBJECTIVES The goal of this study was to quantify the attributable risk of PPMv in patients with SV, and to identify modifiable risk factors. METHODS This international study was sponsored by the Pediatric and Congenital Electrophysiology Society. Centers contributed baseline and longitudinal data for functionally SV patients with PPMv. Enrollment was at implantation. Controls were matched 1:1 to PPMv subjects by ventricular morphology and sex, identified within center, and enrolled at matched age. Primary outcome was transplantation or death. RESULTS In total, 236 PPMv subjects and 213 matched controls were identified (22 centers, 9 countries). Median age at enrollment was 5.3 years (quartiles: 1.5-13.2 years), follow-up 6.9 years (3.4-11.6 years). Median percent ventricular pacing (Vp) was 90.8% (25th-75th percentile: 4.3%-100%) in the PPMv cohort. Across 213 matched pairs, multivariable HR for death/transplant associated with PPMv was 3.8 (95% CI 1.9-7.6; P < 0.001). Within the PPMv population, higher Vp (HR: 1.009 per %; P = 0.009), higher QRS z-score (HR: 1.19; P = 0.009) and nonapical lead position (HR: 2.17; P = 0.042) were all associated with death/transplantation. CONCLUSIONS PPMv in patients with SV is associated with increased risk of heart transplantation and death, despite controlling for increased associated morbidity of the PPMv cohort. Increased Vp, higher QRS z-score, and nonapical ventricular lead position are all associated with higher risk of adverse outcome and may be modifiable risk factors.
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Yu V, Liu H, Zhang L, Fox P, Lonsberry C, Mah D, Cervino L, Yamada Y. Proton and Photon Dosimetry of Carbon Fiber-PEEK Implants for Paraspinal Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choi I, Khan A, Mah D, McCormick B, Tsai H, Rosario GD, Mamary J, Liu H, Fox P, Gillespie E, Braunstein L, Powell S, Cahlon O. Proton Reirradiation for Recurrent or New Primary Breast Cancer in the Setting of Prior Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yan S, Darwish H, Danzi C, Liu H, Mamary J, Sine K, Mah D, Tsai H, Chon B, Cooper B. Reirradiation with Hypofractionated Proton Therapy for Recurrent Lung Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mah D, Branson R. Case Study: Dupuytren's Contracture in a Young Female Powerlifter. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mah D, Yorke E, George J, Han Z, Liu H, Lambiase J, Zemanaj E, Czmielewski C, Gelb E, Li H, McKnight D, Lovelock D, Rimner A, Shepherd A. A Planning Comparison of IMRT Versus Pencil Beam Scanning for Deep Inspiration Breath Hold Lung Cancers. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zaleski KL, Scholl RL, Thiagarajan RR, Porras D, Mah D, DiNardo JA, Nasr VG. Elective Extracorporeal Membrane Oxygenation Support for High-Risk Pediatric Cardiac Catheterization. J Cardiothorac Vasc Anesth 2019; 33:1932-1938. [PMID: 30902553 DOI: 10.1053/j.jvca.2019.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The utility of extracorporeal membrane oxygenation (ECMO) as an elective support modality for high-risk cardiac procedures is extensively described in adults, but its use in children is limited to isolated reports. The objective of this study was to analyze the outcomes of patients who underwent elective cannulation to ECMO for this purpose. DESIGN Single-center, retrospective chart review. SETTING Free-standing pediatric tertiary care center. PARTICIPANTS Patients who underwent elective cannulation to ECMO for cardiorespiratory support during a high-risk cardiac catheterization procedure. INTERVENTIONS Elective ECMO cannulation for high-risk percutaneous cardiac interventions or electrophysiology procedures. MEASUREMENTS AND MAIN RESULTS Survival to discharge was 71.4% compared with 30% for patients who required extracorporeal cardiopulmonary resuscitation in the cardiac catheterization laboratory. The mean duration of cannulation was 137.43 hours (range 27-615 h, median 55 h). There were no major neurologic sequelae, but ECMO circuit thrombosis (57%) was relatively common. CONCLUSION The use of elective ECMO support for high-risk pediatric cardiac catheterizations can be accomplished safely and may allow for an improved rate of survival with lower rates of severe adverse events compared with extracorporeal cardiopulmonary resuscitation as rescue therapy.
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Cooper B, Mah D, Chen C, McCarthy A, Darwish H, Cahlon O, Tsai H, Chon B. Hypofractionated Proton Therapy for Early Stage Non–small Cell Lung Cancer: Clinical Outcomes and Comparative Dosimetric Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Luo L, Cuaron J, Braunstein L, McCormick B, Mah D, Chon B, Tsai H, Powell S, Cahlon O. Outcome and Late Toxicity of Breast Cancer Patients Treated with Post-Mastectomy Proton Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hill KD, Frush DP, Han BK, Abbott BG, Armstrong AK, DeKemp RA, Glatz AC, Greenberg SB, Herbert AS, Justino H, Mah D, Mahesh M, Rigsby CK, Slesnick TC, Strauss KJ, Trattner S, Viswanathan MN, Einstein AJ. Radiation Safety in Children With Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization From the Image Gently Alliance. JACC Cardiovasc Imaging 2017; 10:797-818. [PMID: 28514670 PMCID: PMC5542588 DOI: 10.1016/j.jcmg.2017.04.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/25/2017] [Accepted: 04/28/2017] [Indexed: 02/07/2023]
Abstract
There is a need for consensus recommendations for ionizing radiation dose optimization during multimodality medical imaging in children with congenital and acquired heart disease (CAHD). These children often have complex diseases and may be exposed to a relatively high cumulative burden of ionizing radiation from medical imaging procedures, including cardiac computed tomography, nuclear cardiology studies, and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures. Although these imaging procedures are all essential to the care of children with CAHD and have contributed to meaningfully improved outcomes in these patients, exposure to ionizing radiation is associated with potential risks, including an increased lifetime attributable risk of cancer. The goal of these recommendations is to encourage informed imaging to achieve appropriate study quality at the lowest achievable dose. Other strategies to improve care include a patient-centered approach to imaging, emphasizing education and informed decision making and programmatic approaches to ensure appropriate dose monitoring. Looking ahead, there is a need for standardization of dose metrics across imaging modalities, so as to encourage comparative effectiveness studies across the spectrum of CAHD in children.
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Hu D, Li Y, Zhang J, Pfeiffer R, Gollob MH, Healey J, Harrell DT, Makita N, Abe H, Sun Y, Guo J, Zhang L, Yan G, Mah D, Walsh EP, Leopold HB, Giustetto C, Gaita F, Zienciuk-Krajka A, Mazzanti A, Priori SG, Antzelevitch C, Barajas-Martinez H. The Phenotypic Spectrum of a Mutation Hotspot Responsible for the Short QT Syndrome. JACC Clin Electrophysiol 2017; 3:727-743. [DOI: 10.1016/j.jacep.2016.11.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 11/18/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
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Mah D, Sleeper L, Crosson J, Czosek R, Gamboa D, Love B, McCrindle B, Mosquero LM, Olson A, Shah M, Wechsler S, Young L, Lacro R. RHYTHM ABNORMALITIES IN CHILDREN AND YOUNG ADULTS WITH MARFAN SYNDROME. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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O’Leary E, Alexander ME, Fynn-Thompson F, Mah D. Transvenous approach to pacemaker lead implantation for sinus node dysfunction after extracardiac lateral tunnel Fontan conduit placement. HeartRhythm Case Rep 2016; 2:495-498. [PMID: 28491745 PMCID: PMC5419993 DOI: 10.1016/j.hrcr.2016.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Tang S, Ho M, Rice I, Doan D, Chen C, Mac Rae B, Mah D. SU-F-T-172: A Method for Log File QA On An IBA Proteus System for Patient Specific Spot Scanning Quality Assurance. Med Phys 2016. [DOI: 10.1118/1.4956309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ju N, Chen C, Gans S, Hug E, Cahlon O, Wolden S, Chon B, Yeh B, Tsai H, Sine K, Mah D. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room. Med Phys 2016. [DOI: 10.1118/1.4956346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zheng Y, Flanz J, Mah D, Pankuch M, Beltran C, Robison B, Kreydick B, Schreuder A. SU-F-T-163: Improve Proton Therapy Efficiency: Report of a Workshop. Med Phys 2016. [DOI: 10.1118/1.4956299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chan M, Chen C, Li J, Tang X, Li X, Tang G, Mah D. SU-F-T-173: One-Scan Protocol: Verifying the Delivery of Spot-Scanning Proton Beam. Med Phys 2016. [DOI: 10.1118/1.4956310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hu D, Zhang J, Li Y, Pfeiffer R, Gollob M, Healey J, Harrell DT, Makita N, Abe H, Sun Y, Guo J, Zhang L, Yan G, Mah D, Walsh E, Leopold H, Giustetto C, Gaita F, Mazzanti A, Priori S, Antzelevitch C, Martinez HB. THE PHENOTYPIC SPECTRUM OF MOST FREQUENT MUTATION RESPONSIBLE FOR THE SHORT QT SYNDROME. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30677-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ghelani SJ, Keenan EM, Mah D, Harrild D, Powell A, Geva T, Rathod R. PROLONGED QRS, MECHANICAL DYSSYNCHRONY AND VENTRICULAR DILATION ARE ASSOCIATED WITH VENTRICULAR ARRHYTHMIAS LATE AFTER THE FONTAN OPERATION. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30937-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bui D, Twibill K, Ee D, Mah D, Aleemullah T, Luk S, Kopecny R. Social Media and UNSW Sports Medicine Society: A new face in Sports and Exercise Medicine. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen C, Tang S, Mah D, Chan M. SU-E-T-286: Dose Verification of Spot-Scanning Proton Beam Using GafChromic EBT3 Film. Med Phys 2015. [DOI: 10.1118/1.4924648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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