Introduction: Aconite is commonly used in traditional Chinese medicine but if incorrectly prepared or consumed in excessive doses, can cause significant cardiac toxicity and death. The cardiac sequelae include hypotension, bradycardia, and ventricular arrhythmias, including bidirectional ventricular tachycardia. The diagnosis is made clinically and management is supportive.

Case Report: A 44-year-old male was admitted to the hospital post cardiac arrest. It was discovered that he had ingested significant quantities of the Chinese herbal medication “Fu Zi” or “Aconite” prior to admission. His rhythm on telemetry consisted of monomorphic ventricular tachycardia, bidirectional ventricular tachycardia, and ventricular fibrillation. Repeated cardioversions as well therapy with amiodarone was required. The patient’s arrhythmias subsided after 24 hours, but the patient had developed global hypoxic brain injury and life support was withdrawn.

Conclusion: Given the increasing popularity of herbal products and growing Asian populations in North America, practitioners must have greater awareness of the clinical presentation and consequences of aconite toxicity.

Keywords: Aconite, Bidirectional ventricular tachycardia, Fatal overdose