complete heart block in a patient taking trachyspermum ammi and zingiber officinale

Herbal products are one of the most popular medications in the world. nevertheless, herbal medications are not always safe and several cases of side effects have been reported. a 34 years old man was referred to tehran heart center (thc) for implantation of permanent pacemaker (ppm). recently, he had experienced several episodes of presyncope and according to the diagnosis of complete heart block (chb) with accelerated junctional rhythm, a temporary pacemaker (tpm) was implanted for him in another medical center. he had rheumatoid arthritis, type 2 diabetes mellitus and fatty liver in his past medical history. in his drug history, the patient took only herbal medications for the treatment of his ailments among them daily use of trachyspermum ammi and zingiber officinale (ginger) products were the main causes of this adverse effect.