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Case Reports
. 2024 Jun 29;16(6):e63487.
doi: 10.7759/cureus.63487. eCollection 2024 Jun.

Multiple Episodes of Cardiac Arrest Induced by Treatment With Ibogaine: A Case Report

David Mestre  1 , Alexandra Paula  1 , Francisco P Gil  1 , José Vaz  1
Affiliations
Case Reports

Multiple Episodes of Cardiac Arrest Induced by Treatment With Ibogaine: A Case Report

David Mestre et al. Cureus. .

Abstract

Opioid dependence is a common problem, and therapeutic alternatives are scarce and ineffective. Ibogaine, illegal in several countries, has been reported as a possible therapy in alternative clinics and it is also used as a recreational drug, despite its cardiotoxic potential, including QT prolongation. We report a case of long QT leading to multiple episodes of cardiac arrest after a single dose of ibogaine (200mg, 2.6mg/Kg) in a patient without structural heart disease. This case highlights the fact that even low doses of ibogaine can be lethal and warns us about the consequences of its use.

Keywords: acquired long qt; cardiac arrest; cardiotoxicity; ibogaine; opioid dependence; polymorphic ventricular tachycardia; torsade de pointes.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Electrocardiogram rhythm strip.
Electrocardiogram (ECG) rhythm strip showing life-threatening arrythmia torsade de pointes (black arrow), defibrillation (blue arrow) and sinus rhythm (green arrow).
Figure 2
Figure 2. 12-Lead electrocardiogram after ROSC.
12-Lead electrocardiogram (ECG) after return of spontaneous circulation (ROSC) showing QT prolongation (black arrows) - corrected (QTc) 636 ms (Bazett's formula) - and ventricular bigeminy (blue arrow).
Figure 3
Figure 3. Serial 12-lead ECG exhibiting gradual QT normalization.
A – Electrocardiogram (ECG) at day three with a corrected QT interval of 575 ms (black arrows). B – ECG at day eight with a corrected QT interval of 441 ms (blue arrows). Bazett's formula was used.
See this image and copyright information in PMC

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