J Korean Soc Clin Toxicol.  2011 Dec;9(2):105-108.

A Case of Severe Aconitine Intoxication with Ventricular Tachycardia, Successfully Treated by a Combination of Two Anti-arrhythmic Drugs

• Ryoo SM
• Sohn CH
• Oh BJ
• Kim W
• Lim KS

Abstract

Aconitine is an anti-inflammatory agent with therapeutic uses in oriental medicine as an analgesic and for treatment of stroke. Because of its sodium channel effect, aconitine can promote undesirable, wide complex tachyarrhythmia. If tachycardia develops during use of aconitine, class Ia and class III anti arrhythmic drugs can be utilized for treatment. However there are no single anti-arrhythmia agents which are uniformly effective. We report a case, characterized by wide complex tachyarrhythmia and severe hypotension, which was successfully treated by simultaneous injections of amiodarone and lidocaine. A 59-year-old woman exhibiting clinical signs of drowsiness as a result of ingesting 6 g of aconitine, was admitted to the emergency department. Initially, wide complex tachyarrhythmia (ventricular tachycardia and pulse rate of 180 beats/min) and severe hypotension (blood pressure of 53/26 mmHg) was observed. After simultaneous injection of amiodarone and lidocaine, the patient's rhythm pattern changed to an accelerated junctional rhythm with ventricular premature complex. Two hours later, the patient's heart pattern became a sinus rhythm. As demonstrated by this case, simultaneous injections of amiodarone and lidocaine can be useful in treating ventricular arrhythmia induced by aconitine.

Keyword

Aconitine; Ventricular arrhythmia; Anti-Arrhythmia Agents

MeSH Terms

Aconitine
Amiodarone
Anti-Arrhythmia Agents
Arrhythmias, Cardiac
Emergencies
Female
Heart
Heart Rate
Humans
Hypotension
Lidocaine
Medicine, East Asian Traditional
Middle Aged
Sleep Stages
Sodium Channels
Stroke
Tachycardia
Tachycardia, Ventricular
Therapeutic Uses
Ventricular Premature Complexes
Aconitine
Amiodarone
Anti-Arrhythmia Agents
Lidocaine
Sodium Channels
Therapeutic Uses