Clinical effect of a temporary pacemaker on an electrical storm induced by severe acute aconitine poisoning

Abstract

In China, medicinal liquor made from the aconitine root soaked in wine is poisoned. At present, reliable detoxification drugs are not available. The present study used a temporary pacemaker to treat 12 patients who required treatment due to an electrical storm caused by aconitine poisoning between June, 2017 and April, 2021. The results revealed that temporary pacing was successful in all 12 patients. The electrode placement rate was 100%, and the effective cardiac pacing rate was 100%. The blood pressure of the patients gradually returned to normal levels. Ventricular tachycardia and high-grade atrioventricular block were terminated. As regards atrial premature beats and ventricular premature beats, the sinus rhythm was restored after continuous amiodarone pumping. Simultaneously, fluid supplementation and control supportive treatment were administered. The patients were hospitalized for 4-6 days. The patients' symptoms disappeared, their vital signs were stable and their electrocardiogram (ECG) exhibited normal findings. The 12 patients were followed-up for 1 week following discharge and did not have any discomfort; the ECG revealed no abnormalities. On the whole, the findings of the present study suggest that temporary cardiac pacing may be an effective treatment for malignant arrhythmias caused by severe acute aconitine poisoning. However, the present study only involved a very small number of cases. In the future, further studies are required with larger sample, and further randomized, controlled multi-center studies are also warranted to these findings.