title: Ventricular Tachycardia Precipitated by the Use of the Diet Supplement Hydroxycut Gummies.
abstract: BACKGROUND
  Dietary supplements have a long history of causing adverse effects. Ventricular arrhythmias have not been described with Hydroxycut Gummies.
  
  
  OBJECTIVE
  To report a case of ventricular arrhythmia after prolonged use of a popular dietary supplement, Hydroxycut Gummies.
  
  
  METHODS
  An 18-year-old female with no significant past medical history presented with life-threatening ventricular arrhythmia following about 10 days of use of Hydroxycut Gummies, a legal dietary supplement previously unreported to cause this complication. The patient received external cardioversion due to progressive decline in mental status and persistent hypotension and was initiated on intravenous procainamide at an outside hospital. Left ventricular ejection fraction was 45% to 50%, and cardiac MRI showed no definite finding of infarct, myocarditis, or fibrosis. Beta-blocker therapy was initiated, and there was a progressive reduction in ventricular arrhythmia burden with an improvement of symptoms over the next few days. Two and a half months after the initial hospitalization, follow-up Holter monitor revealed occasional accelerated idioventricular rhythm events and a significant reduction in, but still occasional, long monomorphic ventricular tachycardia events. None of the ingredients listed in this product have been associated with cardiac dysrhythmias in the literature. One phytochemical potentially in the product is alpha-quinidine, which could be the cause of the adverse event. However, there was no other identifiable etiology for the ventricular tachycardia, which resolved after the discontinuation of supplement and the addition of beta-blocker therapy.
  
  
  CONCLUSIONS
  Hydroxycut Gummies should be considered a probable cause of this patient's arrhythmia given the lack of another etiology and a Naranjo Scale score of 6.
authors.affiliation: Clinical Assistant Professor, Department of Pharmacy Practice, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Drayton A
authors.initials: DA
authors.lastname: Hammond
authors.affiliation: Cardiovascular Medicine Fellow, Department of Medicine, University of Florida Health Jacksonville , Florida.
authors.forename: Estela
authors.initials: E
authors.lastname: Thano
authors.affiliation: Clinical Toxicology/Emergency Medicine Fellow, Florida/USVI Poison Information Center - Jacksonville at UF Health Jacksonville , Florida.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Bohnenberger
authors.affiliation: Clinical Pharmacy Specialist - Emergency Medicine, Department of Pharmacy, Columbus Regional Health Midtown Medical Center , Columbus, Georgia.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: McAllister
authors.affiliation: Assistant Professor of Medicine, Section of Cardiac Electrophysiology, University of Florida Health Jacksonville , Florida.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wannenburg
authors.affiliation: Assistant Professor of Medicine, Section of Cardiac Electrophysiology, University of Florida Health Jacksonville , Florida.
authors.forename: Steve
authors.initials: S
authors.lastname: Hsu
authors.affiliation: Professor, Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences , Little Rock, Arkansas.
authors.forename: Bill J
authors.initials: BJ
authors.lastname: Gurley
authors.affiliation: Assistant Professor of Medicine, Section of Cardiac Electrophysiology, University of Florida Health Jacksonville , Florida.
authors.forename: Robert
authors.initials: R
authors.lastname: Kim
keywords: Hydroxycut Gummies; dietary supplement; ventricular tachycardia