Clinical analysis of 19 patients with arrhythmias caused by acute aconitine poisoning

Objectives To explore the clinical characteristics and emergency treatment of patients with arrhythmias caused by acute aconitine poisoning. Methods We conducted a retrospective analysis during the period of 2010 to 2012. Clinical data of patients with arrhythmias caused by acute aconitine poisoning was analyzed. Results A total of 19 patients [male: 79%; age: 49(34-62) years] of acute aconitine poisoning were included. All the 19 cases had arrhythmias according to their electrocardiograms(ECGs), including: sinus bradycardia(heart rate 50 bit/min)(n = 3); junctional escape rhythm(n=1); high degree atrioventricular block(n =2); frequent ventricular extrasystoles(n = 9); ventricular tachycardia(n=3) and ventricular electrical storm(n=1). Ventricular arrhythmia was the most common type. All the cases accepted stomach lavage. Atropine or isoprenaline was given when bradyarrhythmia occurred. There were 6 cases receiving atropine and 1 case receiving isoprenaline. All the cases with ventricular arrhythmia received magnesium sulfate(n=13): 3 cases of ventricular tachycardia were treated with lidocaine; 1 patient with ventricular electrical storm accepted emergent electrical defibrillation for 6 times when ventricular fibrillation occurred, combined with lidocaine and amiodarone injection intravenously. All the 19 cases were cured and discharged from hospital in 24 h. Conclusions Acute aconitine poisoning can lead to various types of arrhythmias, including ventricular electrical storm. The key point of emergency treatment with arrhythmias caused by acute aconitine poisoning is its diagnosis in early stage and early use of antiarrhythmic drugs. When ventricular electrical storm occurs, emergent electrical defibrillation and combining use of lidocaine and amiodarone can increase the success rate.