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Vol. 91, No. 4, 1999
Issue release date: October 1999
Cardiology 1999;91:268–271

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

Guha S. · Dawn B. · Dutta G. · Chakraborty T. · Pain S.
aDivision of Cardiology, Department of Medicine, Calcutta Medical College, Calcutta, India; bDivision of Cardiology, Department of Medicine, University of Louisville, Louisville, Ky., USA

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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.

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