Aconitum plants, including Aconitum carmichaeli Debx.(Chuanwu), Aconitum kusnezoffi Reichb(Caowu), Radix Aconiti lateralis praeparata (Fuzi), etc, have been regarded as a type of warming medicine and been widely used in clinics of Traditional Chinese Medicine (TCM). Aconitine is one of the main effective ingredients of these aconitum herbs. The therapeutic dose of aconitine is close to its toxic dose. Poisoning can be easily induced if aconitum is overdosed or misused, or the herbs are improperly processed and inadequately decocted. Aconitine poisoning can give rise to various symptoms of several systems, among which the cardiovascular toxic symptoms that generally manifested as multiple fatal arrhythmias are particularly conspicuous. Currently, the certain mechanism of aconitine induced arrhythmias remains unclear due to the complexity. Thus, we summarized the proarrhythmic toxic mechanisms of aconitine by collecting and integrating the correlational research reports.