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

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

Abstract readCase Reports

In one paragraph

Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Cheng YangEmergency Department, Dangtu People's Hospital, Maanshan 243100, Anhui, China.

Ting ZouInfectious Diseases Department, The First Hospital of Jiaxing, The Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China.

Qian-Hui ZangEmergency Department, The First Hospital of Jiaxing/The Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing, 314000, Zhejiang, China.

Wei CaoEmergency Department, The First Hospital of Jiaxing/The Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing, 314000, Zhejiang, China.

Yuan SuoEmergency Department, The First Hospital of Jiaxing/The Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing, 314000, Zhejiang, China. syting0114@zjxu.edu.cn.

Funding

Jiaxing Emergency Medicine Key Supporting Discipline Construction Project 2023-ZC-04

6 · The paper itself

Abstract

introductionAconitine 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%).

conclusionsCombined antiarrhythmic therapy and blood purification proved effective. Early recognition and integrated care are key to managing aconitine poisoning.

Indexed as

AconitineAnti-Arrhythmia AgentsArrhythmias, CardiacHemoperfusionAgedDrugs, Chinese HerbalHumansMaleAconitineAnti-Arrhythmia AgentsDrugs, Chinese HerbalAconitine poisoningArrhythmiaBlood purificationComprehensive treatment strategyElectrical cardioversionHypotension

Identifiers

PMID41023722

DOI10.1186/s40001-025-03167-1

PMCPMC12482442

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.