Reversibility of a High-Grade Atrioventricular Block Treated HomeopathicallyFunding No funding was received for this study.
Background A 61-year-old female patient requested a homeopathic therapy as an alternative to a pacemaker for a non-acute myocardial infarction, high-grade atrioventricular node block (HG-AVNB) with a narrow QRS complex.
Methods Homeopathic Digitalis purpurea (Digitalis) was employed to accelerate the patient's heart rate.
Results Digitalis caused within 3 days a pulse rate of about 90 beats per minute (bpm) which is represented on the electrocardiogram (ECG) by an accelerated junctional rhythm (AJR).
The AJR compelled seeking a medicine to reduce its rate. Homeopathic Arsenicum album (Arsenicum) reduced its rate and also seemed to have assisted in the unanticipated recovery of the atrioventricular node (AVN).
Conclusions This case report represents, an ECG documented case of a medical treatment modality which could be an alternative to pacemakers for patients with a HG-AVNB with a narrow QRS complex. Digitalis has been safe and effective during its 3 and a half year employment.
Keywordshigh-grade atrioventricular node block - homeopathic Digitalis purpurea - accelerated junctional rhythm - case report - homeopathy
Informed consent for the publication was given by the patient. The signed document is confidential.
08 April 2021 (online)
© 2021. Thieme. All rights reserved.
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Riley DS, Barber MS, Kienle GS. et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 2017; 89: 218-235 . Elsevier BV. Accessed December 28 2017 at: https://www.jclinepi.com/article/S0895-4356(17)30037-9/fulltext
- 2 Lamba CD, Gupta VK, van Haselen R. et al. Evaluation of the Modified Naranjo Criteria for Assessing Causal Attribution of Clinical Outcome to Homeopathic Intervention as Presented in Case Reports. Homeopathy [Internet]. Georg Thieme Verlag KG. ; 2020 Mar 25. Accessed April 24, 2020 at: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1701251
- 3 Tracy CM, Epstein AE, Darbar D. et al. 2012 ACCF/AHA/HRS focused update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Heart Rhythm 2012; 9 (10) 1737-1753 . Elsevier BV. Accessed July 19, 2017 at: https://www.ahajournals.org/doi/full/10.1161/cir.0b013e3182618569
- 4 Carrión-Camacho MR, Marín-León I, Molina-Doñoro JM, González-López JR. Safety of Permanent Pacemaker Implantation: A Prospective Study. J Clin Med 2019; 8 (01) 35 . MDPI AG. Accessed June 10, 2020 at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352172/
- 5 Cardoso R, Alfonso CE, Coffey JO. Reversibility of high-grade atrioventricular block with revascularization in coronary artery disease without infarction: a literature review. Case Rep Cardiol 2016; 2016: 1971803 . Accessed June 22, 2020 at: https://www.hindawi.com/journals/cric/2016/1971803/
- 6 Nash EB. Leaders in Homœopathic Therapeutics. Boericke and Tafel, 3rd edition 1907. See page 190. Accessed February 10, 2021 https://ia600304.us.archive.org/1/items/leadersinhomopa02nashgoog/leadersinhomopa02nashgoog.pdf
- 7 McGreevy J, Perlis C. Cutting edge or cutting corners? Innovative care. In: Bercovitch L, Perlis C. eds. Dermatoethics. London: Springer; 2012
- 8 Tenzera L, Djindjic B, Mihajlovic-Elez O, Pulparampil BJ, Mahesh S, Vithoulkas G. Improvements in long standing cardiac pathologies by individualized homeopathic remedies: a case series. SAGE Open Medical Case Reports [Internet]. SAGE Publications; 2018 Jan;6:2050313 × 1879281. Accessed September 18, 2020 https://journals.sagepub.com/doi/full/10.1177/2050313×18792813
- 9 Scala PB. Homeopathic treatment of two patients with coronary artery disease: case-report. Int J High Dilution Res 2009;8(27):45–49. Accessed September 18, 2020 https://highdilution.org/index.php/ijhdr/article/view/337/391
- 10 Zhang D, Wang W, Li F. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis. CMAJ 2016; 188 (15) E384-E392 . Joule Inc. Accessed July 10, 2017 at: https://www.cmaj.ca/content/188/15/E384
- 11 Omeroglu SN, Ardal H, Erdogan HB. et al. Can revascularization restore sinus rhythm in patients with acute onset atrioventricular block?. J Card Surg 2005; 20 (02) 136-141 . Accessed June 23, 2020 at: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0886-0440.2005.200369pl.x
- 12 Mosseri M, Izak T, Rosenheck S. et al. Coronary angiographic characteristics of patients with permanent artificial pacemakers. Circulation 1997; 96 (03) 809-815 . Accessed June 23, 2020 at: https://www.ahajournals.org/doi/10.1161/01.CIR.96.3.809
- 13 Yesil M, Bayata S, Arikan E, Yilmaz R, Postaci N. Should we revascularize before implanting a pacemaker?. Clin Cardiol 2008; 31 (10) 498-501 . Accessed June 23, 2020 at: https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.20280
- 14 Hwang I-C, Seo W-W, Oh I-Y, Choi E-K, Oh S. Reversibility of atrioventricular block according to coronary artery disease: results of a retrospective study. Korean Circ J 2012; 42 (12) 816-822 . Accessed June 23, 2020 at: https://e-kcj.org/DOIx.php?id=10.4070/kcj.2012.42.12.816
- 15 Kim D, Shinohara T, Joung B. et al. Calcium dynamics and the mechanisms of atrioventricular junctional rhythm. J Am Coll Cardiol 2010; 56 (10) 805-812. Elsevier BV . Accessed July 02, 2017 at: https://www.onlinejacc.org/content/accj/56/10/805.full.pdf?download=true