Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 4 3-4 2018 02 03 91 92 EN Hesamoddin Hosseinjani Fellowship of Critical Care in Pharmacotherapy, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Saeed Sadeghian Associate Professor, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Azita Hajhossein Talasaz Associate Professor, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 11 20 2016 12 13 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. https://jpc.tums.ac.ir/index.php/jpc/article/view/130 https://jpc.tums.ac.ir/index.php/jpc/article/download/130/112