• atrial fibrillation

    Prominent publications by Simon Milstein

    KOL Index score: 12642

    Neurally mediated hypotension and bradycardia are believed to be common causes of syncope. We used the "upright-tilt test" (duration, less than or equal to 10 minutes) with or without an infusion of exogenous catecholamine (isoproterenol [1 to 5 micrograms per minute], given intravenously) to elicit bradycardia, hypotension, or both in 24 patients with recurrent syncope and in 18 control subjects. A conventional electrophysiologic test performed before the tilt test was positive in 9 of ...

    Also Ranks for: Recurrent Syncope |  hypotension bradycardia |  isoproterenol infusion |  tilt test |  15 patients
    KOL Index score: 11264

    The effect of surgical ablation of ablation of atrioventricular accessory pathways on the incidence of atrial fibrillation in patients with Wolff-Parkinson-White syndrome was examined and the results of preoperative electrophysiologic testing were studied to determine factors predictive of outcome. Among 50 consecutive surgical cases, 19 patients were identified with a past history of at least one episode of spontaneous atrial fibrillation documented by electrocardiogram before surgery. ...

    Also Ranks for: Atrial Fibrillation |  white syndrome |  accessory pathway |  surgical ablation |  reciprocating tachycardia
    KOL Index score: 10270

    Head-up tilt testing has gained acceptance as a tool for assessing susceptibility to neurally mediated syncopal syndromes (e.g., vasovagal syncope), and is currently being evaluated as a means of testing therapeutic interventions in these conditions. To assess reproducibility of head-up tilt testing and thereby assess the potential of such testing for immediate evaluation of a planned treatment, findings during 2 sequential 80 degrees head-up tilt tests were compared in 23 patients (age ...

    Also Ranks for: Syncope Tilt |  23 patients |  neurally mediated |  structural heart disease |  table testing
    KOL Index score: 10110

    To assess the efficacy and safety of intravenous diltiazem, 54 patients with inducible sustained supraventricular tachycardia received diltiazem, 0.25 mg/kg or 0.25 mg/kg, followed by 0.35 mg/kg body weight, or placebo in a double-blind, randomized study. Twenty patients had atrioventricular (AV) node reentrant tachycardia, whereas 34 had orthodromic AV reciprocating tachycardia associated with the Wolff-Parkinson-White syndrome. Supraventricular tachycardia was terminated in 24 (86%) of ...

    Also Ranks for: Intravenous Diltiazem |  supraventricular tachycardia |  sinus rhythm |  20 patients |  multicenter study
    KOL Index score: 8703

    Susceptibility to transient hypotension-bradycardia of neurally mediated origin has been attributed in part to accentuated afferent neural traffic arising from cardiopulmonary mechanoreceptors, and consequently, may be diminished by agents with anticholinergic and negative inotropic effects, such as disopyramide phosphate. This study assessed electrocardiographic and hemodynamic responses to upright tilt testing (alone or during isoproterenol infusion) before and after disopyramide ...

    Also Ranks for: Upright Tilt |  10 patients |  heart rate |  hypotension bradycardia |  arterial pressure
    KOL Index score: 8222

    Preexcitation of the atria during reciprocating tachycardia (RT) by a premature ventricular complex occurring when the His bundle is refractory provides direct evidence of the presence of accessory atrioventricular (AV) connection. The impact of ventricular stimulation site and RT cycle length on inducibility of atrial preexcitation was assessed in 38 patients with RT utilizing a single accessory AV connection (right free wall in 5 patients, left free wall in 21 and posterior ...

    Also Ranks for: Cycle Length |  atrial preexcitation |  free wall |  premature cardiac pacing |  reciprocating tachycardia
    KOL Index score: 7801

    Two patients are described who had recurrent and long-standing atrial flutter of the common type and were referred for electrophysiologic testing and surgical management. In both patients, atrial flutter could be initiated and terminated by programmed stimulation. Atrial endocardial mapping showed earliest activation during flutter at the orifice of the coronary sinus, with activity proceeding to the low atrial septum, high lateral right atrium and low right atrium, respectively. ...

    Also Ranks for: Atrial Flutter |  common type |  coronary sinus |  operative therapy |  low atrium
    KOL Index score: 7770

    Electrophysiologic testing in patients with asymptomatic Wolff-Parkinson-White syndrome (WPW) may be useful in defining arrhythmic substrates and predictors of fatality. Forty-two patients with asymptomatic WPW, mean age 36 years, underwent electrophysiologic studies and were followed prospectively. They were compared with a matched control group of patients studied within the same period for documented tachycardia associated with the WPW syndrome. Asymptomatic patients had longer ...

    Also Ranks for: Asymptomatic Wolff |  electrophysiologic profile |  accessory pathway |  wpw syndrome |  atrial fibrillation
    KOL Index score: 7761

    We have described a closed-heart technique for division of atrioventricular (AV) pathways in Wolff-Parkinson-White (WPW) syndrome. The technique involves dissection and mobilization of the AV fat pad with exposure and cryoablation of the AV junction at the site of the AV pathways. One hundred five consecutive patients with WPW syndrome with left ventricular free wall (74), posterior septal (23), and right ventricular free wall AV pathways (11) were operated on between July, 1982, and ...

    Also Ranks for: White Syndrome |  pathway conduction |  closedheart technique |  patients operation |  wolff parkinson
    KOL Index score: 7650

    Concomitant susceptibility to atrioventricular (AV) node reentrant tachycardia has been demonstrated in certain patients having reentrant tachycardia utilizing accessory AV connections. For those patients undergoing accessory connection ablation, AV node surgical modification may be warranted during the same operative procedure. To assess indications for a combined operative procedure, this study evaluated potential predictors of subsequent spontaneous AV node reentrant tachycardia in ...

    Also Ranks for: Surgical Ablation |  atrioventricular node |  reentrant tachycardia |  pathways patients |  7 months
    KOL Index score: 7428

    This study assessed the temporal relation of RR interval, AH interval and systemic blood pressure changes during induced symptomatic bradycardia-hypotension episodes in 14 patients with recurrent syncope suspected of being neurally mediated. Upright tilt with isoproterenol reproduced symptoms in 9 of 14 patients (positive response) and was negative in 5 of 14 (negative response). Isoproterenol alone shortened supine RR intervals in all patients. With tilt, however, isoproterenol ...

    Also Ranks for: Patients Tilt |  neurally mediated |  positive responses |  bradycardia hypotension |  recurrent syncope
    KOL Index score: 7398

    This study examined the effectiveness of intravenous amiodarone for rapid control and prevention of recurrent life-threatening ventricular tachyarrhythmias associated with cardiovascular collapse. In 22 critically ill patients with coronary artery disease (mean ejection fraction 27 +/- 13%), recurrent ventricular tachyarrhythmias proved refractory to 3.7 +/- 1.1 (mean +/- standard deviation) conventional antiarrhythmic drugs. In the 24-hour period before intravenous amiodarone treatment, ...

    Also Ranks for: Intravenous Amiodarone |  coronary artery disease |  rapid treatment |  threatening ventricular |  24 hours
    KOL Index score: 7058

    Adenosine has become the drug of choice for termination of regular, normal QRS tachycardia. Initial studies in adult and pediatric patients have shown that the drug is effective for tachycardias using the atrioventricular (AV) node as an integral part of the tachycardia circuit and has few serious side effects. Experience with adenosine administration in children was reviewed to examine the diagnostic and therapeutic usefulness, effective dose, and adverse effects of adenosine. Adenosine ...

    Also Ranks for: Ventricular Tachycardia |  children adenosine |  atrial fibrillation |  nodal reentry |  drug interactions
    KOL Index score: 6841

    It has been proposed that prolonged cardiac asystole mimicking an episode of sudden cardiac death may occur as a manifestation of neurally mediated hypotension-bradycardia syndrome. To assess this possibility, electrocardiographic and hemodynamic findings during upright tilt testing were evaluated in six survivors of suspected asystolic sudden cardiac arrest with normal conventional electrophysiologic evaluation (Group I). These observations were compared with findings in two control ...

    Also Ranks for: Cardiac Asystole |  heart rate |  neurally mediated |  patients syncope |  arterial pressure


    Simon Milstein: Influence Statistics

    Sample of concepts for which Simon Milstein is among the top experts in the world.
    Concept World rank
    effectiveness tachycardia reinitiation #1
    effective tachycardias #1
    adenosine 38 children #1
    ventricular theophylline adenosine #1
    tachycardia effectiveness #1
    ventricle observation #1
    atrioventricular ring base #1
    principle widespread success #1
    1 patient adenosine #1
    adenosine administration children #1
    base atrial appendage #1
    children adenosine #1
    arm exercise place #2
    tachycardia preoperatively #2
    adenosine children #2
    accessory connection patients #2
    arm walk #2
    new insight heart #2
    patients reentrant tachycardia #2
    officebased exercise protocol #2
    psychological syncope cardioneurogenic #2
    rationale proposed protocols #2
    strappedon devices #2
    therapies supraventricular #2
    low activity threshold #2
    node echo beats #2
    upright body tilt #2
    operative procedure indications #2
    cardioneurogenic protocols #2
    implanted strapped #2
    eliciting susceptibility #2
    syncopal syndromes #2
    settings pacing rates #2
    rates strapped #2
    preoperatively recurrence #2
    predicting chronotropic #2
    rates implanted #2
    tilt 23 patients #2
    accessory connections patients #2
    implanted devices differences #2
    implanted devices place #2
    strapped implanted #2
    coexisting dual #2
    office clinic environment #2
    settings pacing #2

    Key People For Atrial Fibrillation

    Top KOLs in the world
    Gregory Yoke Hong Lip
    atrial fibrillation heart failure stroke prevention
    John Camm MD John Camm
    atrial fibrillation myocardial infarction heart rate
    Emelia J Benjamin
    atrial fibrillation framingham heart study heart failure
    Harry J G M C Crijns
    atrial fibrillation heart failure sinus rhythm
    Isabelle C Van Gelder
    atrial fibrillation heart failure rate control
    Stefan Hans Hohnloser
    atrial fibrillation myocardial infarction sinus rhythm

    Simon Milstein:Expert Impact

    Concepts for whichSimon Milsteinhas direct influence:Atrial fibrillation,  Surgical ablation,  Cycle length,  Intravenous diltiazem,  Recurrent syncope,  Accessory pathway,  Atrioventricular node,  Ventricular fibrillation.

    Simon Milstein:KOL impact

    Concepts related to the work of other authors for whichfor which Simon Milstein has influence:Atrial fibrillation,  Vasovagal syncope,  Supraventricular tachycardia,  Accessory pathway,  Catheter ablation,  Heart rate,  Tilt test.



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    From the Cardiac Arrhythmia Center (R.J., G.A.T., S. Sattiraju, J.N., S. Sakaguchi, F.L., C.E., S.M., K.L., D.G.B.), Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minn; and Central Minnesota Hea