Holter monitor

A holter monitor or ambulatory electrocardiography device is a portable equipment that is used to monitor electrical activity of the heart. There are a series of electrodes attached to the chest of the patient that can record electrical signals from the heart. There is a recording monitor that can be carried in the pocket or worn around the neck. The patient's EKG for 24 hours is recorded. Values such as average heart rate, maximum and minimum heart rate are calculated. ECG tracing using Holter monitor is conducted on patients who suffer prolonged fatigue and episodes of low blood pressure and fainting. A Holter monitor aids in recording any abnormal activity of the heart. The Holter monitor is worn by the patient as he/she goes about his daily routine. It is possible to observe occasional cardiac arrhythmias, atrial fibrillation and atrial tachycardia with a Holter monitor. This device is also adviced for patients who have suffered a heart attack or under cardiac medication. A Holter monitor aids in monitoring the performance of a heart pacemaker. Smoking and close proximity to devices such as magnets and metal detectors and some electrical appliances can affect the Holter monitor readings.

Cardiac Arrhythmia

Cardiac arrhythmia refers to a disturbance of the heart rhythm. When the regular heart rhythm is disturbed, it can lead to symptoms that can range from mild to life-threatening. The heart may have slower beats or there may be a blockage of the electrical pathway of the heart. One of the most common form of cardiac arrhythmia is atrial fibrillation. This occurs in older persons when the upper atrial chambers of the heart do not pump correctly. This can lead to blood clots. Heart failure or electrolyte imbalance can bring on cardiac arrhythmia.

Tachycardia is a condition where there is rapid heartbeat due to inefficiency in the blood circulation. Tachycardia is a condition where the heart rhythm is more than 100 beats/minute. This can happen due to stress, hyperthyroidism or alcohol. On the other hand, Bradycardia is a condition where the heart rhythm is less than 60 beats/min. A ventricular arrhythmia can be life-threatening. This happens when there is ventricular fibrillation. It is essential to treat this condition and restore the rhythm within minutes to prevent heart damage and death. Allergic reactions can trigger arrhythmias.

Some persons suffering from cardiac arrhythmia notice symptoms such as dizziness, fainting and lightheadedness. There may be a fluttering or pounding sensation in the chest. Antiarrhythmic agents such as amiodarone and sotalol are prescribed to maintain the normal rhythm of the heart. In cases of atrial fibrillation, warfarin is used to prevent blood clots. Medication for cardiac arrhythmia includes beta blockers such as metoprolol and atenolol to reduce the heart rhythm. An electronic cardiac pacemaker may be implanted to regulate the heart beat.

Venlafaxine

Indication

A new class of antidepressant medications, unrelated to the tricyclic antidepressants, used in the treatment of depression.

Side effects

Anxiety, somnolence, dizziness, dry mouth, nausea, abnormal ejaculation (male), impotence, headache, tremor, blurred vision, asthenia, sweating, nervousness, hypertension, and insomnia have been the most commonly reported. Changes in weight, appetite and allergic reactions have also been reported more infrequently. Other less common effects include infection, chills, chest pain, tachycardia, rash, constipation, abnormal dreams, paraesthesias, depression, urinary retention, twitching, change in taste, and tinnitus.

Interactions and precautions
1. Use with caution and at a reduced dosage in those with, liver impairment.
2. Consider overall risk-benefit in those with hypertension.
3. Do not use with alcohol.
4. Do not use with Mao inhibitors--fatal interaction can result.
5. Potential for interaction with over-the-counter cold remedies, consult you physician before use.
6. Use with cimetidine could potentiate the effects of venlafaxine. A dosage reduction (venlafaxine) may be necessary in some individuals.

Usual dose

Adults: oral, 75 mg per day in two to three dicided doses, taken with food.