Bradycardia, Reversible Panconduction Defect and Syncope following Self-Medication with a Homeopathic Medicine

Abstract

Alkaloid extracts from the plant Aconitum species have been used in various forms of herbal remedies predominantly as anti-inflammatory and analgesic agents. Many of these alkaloids are extremely potent cardiotoxins and documented cases of various arrhythmias with fatal outcomes have been reported. We report a case of self-medication with ‘tincture of aconite’ resulting in severe bradycardia, reversible panconduction defect evidenced by sinus inactivity, atrioventricular dissociation with idiojunctional rhythm and left bundle branch block pattern resulting in hypotension and syncope. Complete reversal of ECG findings with marked improvement in symptoms was noted within a few hours. Herbal medicines containing aconite alkaloids may result in severe cardiotoxicity, and strict regulatory measures are warranted to curb unsupervised use for therapeutic purposes.

Adverse effects of homeopathy: a systematic review of published case reports and case series

“…Our searches generated 378 articles, of which 340 had to be excluded (Figure 1). Thus, 35 reports met our eligibility criteria (5–40). Table 1 summarises direct AEs associated with the use of homeopathy.…”

“…The total number of patients amounted to 1159 (of those 1142 AEs were classified as direct and 17 as indirect AEs). The included articles originated from Austria, (5) Belgium, (20,31) Brazil, (16) Denmark, (23) France, (10,13,15) Germany, (36,38,40) Holland, (37) India, (32) Ireland, (18) Israel, (9,17,26) Italy, (11) Mexico, (29) Spain, (6,8,33) Sweden,(19) Switzerland, (25,39) UK(21,28) and the US (14,22,24). They were published between 1978 and 2010.…”

“…The duration of AEs ranged from a few hours (22) to 7 months (9,16). Eighteen patients experienced a full recovery (6,7,(9)(10)(11)(12)14,16,18,(21)(22)(23)(24)(25)(29)(30)(31)33,35,36,39) and four died (8,26,32,41). In six cases, details of AEs were insufficient for a judgment regarding cause and effect (13,19,27,28,34,37,38,40).…”

Native Medicines and Cardiovascular Toxicity

“…Cardiac effects are clinically similar to cardiac glycoside toxicity with enhanced vagal tone. 22,28 Hypokalemia; metabolic or respiratory acidosis; respiratory alkalosis; and renal, hepatic, and central nervous system impairment may be noted.…”

Vitamins, Supplements, Herbal Medicines, and Arrhythmias

“…Bradycardia, panconduction defects manifested by sinus arrest, atrioventricular dissociation with idiojunctional rhythm, and left bundle branch block resulting in hypotension and syncope has been reported. 132 Broom has been used as a cathartic, emetic, diuretic, decongestant, and antiarrhythmic agent, but is considered unsafe by the FDA. 77 Sparteine, an alkaloid derivative, has been used to induce labor as an oxytocic agent and also as an antiarrhythmic agent.…”