After Open Heart Surgery:The Holter Monitor Experience

If heart palpitations develop,you may be referred to your local hospital cardiology department for attachment of an ambulatory electrocardiogram,or Holter monitor.This ingenious device was developed by Norman Holter,MD in the late 1940s.It is the size of a deck of cards and originally was a tape recorder;today,it is commonly a digital recorder with a flash card.Usually worn for 24 hours,the little machine is powered by two AA batteries and is connected to the chest by a number of electrodes,or leads.
The Holter monitor is indicated when a patient is suspected of possibly having a cardiac arrhythmia.It gives the medical team an extended look at the patient's heart rate and rhythm.Even silent abnormalities,of which the patient is unaware,may be detected.
A few emergency situations are detected by the monitor and the patient must be hospitalised.Mostly,patients are found to have a condition either not requiring treatment or one that may be addressed at the standard pace.
The monitor is clipped to your belt,put in your shirt pocket,or worn around your neck.As well,the patient fills out a short but carefully timed diary of activities and symptoms to aid in the interpretation of the data,which are uploaded to a computer with analytical software when the monitor is removed.The software flags any irregularities for the technician and cardiologist to focus on along with the diary material.
Wearing the device is mildly stressful as you wonder whether it will remain properly attached for the whole period and so on,as well as what the results could portend for you.
What you and your family would do if it recorded a serious problem is something that occurs to you.Perhaps you will not be so eager to get that telephone call when the report is in.On the other hand,you are intrigued by the science and engineering and curious about what is going on internally.
Probably it is nothing,you think,or else it will lead to more testing.Among the undesirable scenarios,you may need an implantable medical device such as a pacemaker or defibrillator.Maybe they will put you back on the anticoagulant Warfarin.
It is all a part of being a heart patient,a role you didn't seek but you might as well excel at along with all else in your life,for the benefit of everyone concerned.
The British firm Cardionetics makes a Holter monitor which analyses the data on its own.

Atrial Fibrillation:A Big Problem Getting Bigger

Atrial Fibrillation,or AFib,is a heart rhythm disorder which is sweeping through the growing ranks of the elderly.That's understandable,since age is one of the main predispositions for the disease.From a current patient population of about 5 million,the number of AFib patients is expected to triple by 2050.Many of them are already dealing with other chronic diseases-especially cardiovascular ones.
In AFib,the two upper chambers of the heart,or atria,beat erratically and out of sync with the two lower chambers,or ventricles.This can result in a number of symptoms such as heart palpitations;lightheadedness;fatigue;shortness of breath;disorientation;and even chest pain.During AFib,an electrical overload in the heart results in an irregular,rapid heartbeat.These erratic signals may be caused by factors such as damage to the heart's structure from hypertension;heart valve disease;heart attacks;congenital heart defects;metabolic disorders;lung disease;stimulants;heart surgery;viral infection;and sleep apnea.Age,alcoholism and heredity may predispose a patient for AFib.
AFib can lead to stroke and heart failure.Left untreated,it tends to become more severe and less amenable to treatment as time goes on.Recent studies point to a link between AFib and dementia.That stands to reason,since AFib can easily hinder blood flow to the brain.
AFib is typically diagnosed by means of various monitors attached to the body with electrodes.Treatment ranges from medication to electric shock therapy,as well as various catheter procedures.Blood thinners such as Warfarin and its branded form Coumadin,plus the newer Pradaxa are frequently prescribed to lesson the considerable risk of blood clot formation and stroke from AFib.
If your heart seems to be acting up,it's best to consult with your doctor about it.It could be AFib or another dangerous cardiac arrhythmia.
German pharmaceutical company Boehringer Ingelheim,which is privately held,makes Pradaxa,while Coumadin is a product of Bristol-Myers Squibb.
Bristol-Myers Squibb(BMY)

Understanding Heart Palpitations

Those strange sensations in your chest can be quite concerning.They may be felt as a fluttering in the chest;the heart skipping a beat;the heart racing;an extra heartbeat;a pounding heartbeat;even a throbbing in your neck.
An occasional palpitation is felt by nearly everyone at some time or other.It's probably just from stress;fatigue;caffeine;nicotine;or possibly cold medicine with a stimulant in it.
If your palpitations are frequent,though,or accompanied by other symptoms,such as lightheadedness or dizziness,you need to have a doctor evaluate them.They could be a sign of a dangerous heart condition called atrial fibrillation,or other cardiac arrhythmias.
You may be referred to a cardiologist,who can order various tests to study the problem with.These may include an electrocardiogram;a Holter monitor;an event monitor;possibly an echocardiogram or chest x-ray.None of them hurt.It's detective work,and it can be challenging to catch the palpitations and record them for analysis,which may also require your keeping a diary of activities and symptoms.That's why it may take several weeks to understand your condition and begin treating it,if necessary.
Anything that worries you about your health is worth looking into.With determination,you and your doctor will reach the right conclusion.

Bristol-Myers/Pfizer Drug Apixiban Superior to Aspirin For AF Patients

A Phase 3 trial of the Bristol-Myers Squibb/Pfizer oral medication apixiban showed that,for atrial fibrillation patients unsuitable for a vitamin K antagonist such as warfarin,apixiban is superior to aspirin at reducing the risk of stroke or systemic embolism without a significant increase in major bleeding(annual event rate of 1.6% for apixiban versus 3.7% for aspirin).
The study also showed that apixiban was superior to aspirin at reducing the composite of stroke,systemic embolism,heart attack or vascular death for AF patients versus aspirin(annual event rate of 4.2% for apixiban versus 6.7% for aspirin).
Atrial fibrillation is the most common sustained cardiac arrhythmia.It afflicts about 5.1 million Americans and more than 6 million Europeans.About 40-50% of AF patients are considered unsuitable for vitamin K antagonists because of the risk of bleeding and incompatibility with other medications.
Lead investigator Dr.Stuart Conolly,MD,professor of medicine at McMaster University in Hamilton,Ontario,said the risk of stroke or systemic embolism is of great concern for patients with atrial fibrillation,especially because AF-related strokes are particularly devastating.Given the significant number of patients who are not eligible for vitamin K antagonists,it is especially important to have potential new treatment options that are both safe and effective.
Pfizer and Bristol-Myers have been in a worldwide collaboration to develop and commercialize apixiban since 2007.
Bristol-Myers Squibb(BMY),Pfizer(PFE)