<s>[INST] Dear Dr. PrabhakarI have been taking Aritel 40 for about a yr.Lately I am having lot of dizziness.The ECG shows missed beats .say between 10 and15 per minute,and also IVCD.Occaisionally ,the heart rate drops to 46 per minute on standing up.Could this problem be due to Eritel?ThankyouRM [/INST] Hello,  Eritel per say doesn't affect heart rate,  however many a times if your blood pressure is over treated you may have dizziness when you suddenly get up   this is called ortho static hypotension.  However if your ecg shows so many missed beats (considered significant when more than 10 beats),  and IVCD is too non specific, the missed beat may be the reason for dizziness in all probability.  Do upload the ecg or visit your cardiologist with the same for accurate diagnosis. The next test is 24 hour holter Also don't worry just a medication would be the treatment,  it's just titration of dose of the medication can be done easily after final diagnosis is made.  Regards Dr Priyank Mody </s>