Work

Combined blood purification and antiarrhythmic therapy for acute aconitine poisoning with refractory arrhythmias: a case-based mechanistic evaluation and treatment strategy optimization

Year: 2025

Type: article

Abstract: INTRODUCTION: Aconitine poisoning from traditional Chinese medicine is life-threatening, associated with arrhythmias and shock. Early diagnosis and multidisciplinary treatment are essential due to the lack of specific antidotes. This study aimed to present a severe case of aconitine poisoning and to evaluate the effectiveness of combined blood purification and antiarrhythmic therapy, thereby providing practical insights for clinical management. A 70-year-old man presented with coma, recurrent ventricular arrhythmias, and severe hypotension (nadir: 44/24 mmHg) after ingesting Fuzhi (Aconitum taipeicum). Toxicology confirmed high aconitine levels. He was treated with norepinephrine (0.17-0.33 μg/kg/min), intravenous amiodarone (150 mg bolus over 10-15 min, then 1 mg/min infusion), electrical cardioversion, and early blood purification (hemoperfusion + CVVH). He regained hemodynamic stability within 24 h and fully recovered at 6 months (LVEF 59-63%). CONCLUSIONS: Combined antiarrhythmic therapy and blood purification proved effective. Early recognition and integrated care are key to managing aconitine poisoning.

Source: European journal of medical research

DOI: 10.1186/s40001-025-03167-1

Authors: Cheng Yang, Ting Zou, Qian-Hui Zang, Wei Cao, Yuan Suo

Institutions: Jiaxing University, First Hospital of Jiaxing

Language: English

Topic: Plant-based Medicinal Research

Subfield: Pharmacology

Field: Pharmacology, Toxicology and Pharmaceutics

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190