What major cardiac risk is associated with the use of ibogaine?

Ibogaine, a psychoactive substance derived from the iboga plant, is known to have various effects on the cardiovascular system, one of the most significant being its association with QT prolongation. This prolongation refers to an extended interval on an electrocardiogram (ECG), which indicates a delay in the electrical repolarization of the heart after a heartbeat.

QT prolongation is particularly concerning because it can lead to potentially life-threatening arrhythmias, such as torsades de pointes, which can result in sudden cardiac arrest. The mechanism behind this effect often involves the inhibition of cardiac ion channels, particularly the hERG potassium channel, which is critical in cardiac repolarization. Given the risk of these severe outcomes, monitoring an individual's cardiac health during ibogaine treatment becomes crucial.

Other cardiac risks associated with different conditions or medications may exist, but in the context of ibogaine use, QT prolongation is the most significant and well-documented risk, emphasizing the importance of careful ECG monitoring and evaluating the risk versus benefit when considering ibogaine therapy.