Treating Lyme carditis high-degree AV block using a temporary-permanent pacemaker

Ann Noninvasive Electrocardiol. 2019 May;24(3):e12599. doi: 10.1111/anec.12599. Epub 2018 Sep 28.

Abstract

A 28-year-old previously healthy male presented with nonprodromal syncope and a 4-day history of chest pain, shortness of breath, and malaise. His ECG showed rapidly progressive high-degree AV block. His Suspicious Index in Lyme Carditis (SILC) score was 8, indicating high risk for Lyme carditis. Lyme serology revealed to be positive (anti-Lyme IgM). During the second day of hospitalization, the patient deteriorated his AV conduction, and a temporary-permanent pacemaker was implanted allowing ambulating in hospital the very same day. Temporary-permanent pacemakers for the management of transient high-degree heart block associated with Lyme carditis were only occasionally used in the past.

Keywords: bradyarrhythmias; conduction disturbances; electrophysiology; implantable devices; lead implantation/extraction; pacemaker.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Atrioventricular Block / diagnostic imaging
  • Atrioventricular Block / etiology*
  • Atrioventricular Block / therapy
  • Borrelia burgdorferi / isolation & purification
  • Chest Pain / diagnosis
  • Chest Pain / etiology
  • Diagnosis, Differential
  • Disease Progression
  • Electrocardiography / methods
  • Emergency Service, Hospital
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Lyme Disease / complications*
  • Lyme Disease / diagnosis*
  • Male
  • Myocarditis / diagnostic imaging
  • Myocarditis / etiology*
  • Myocarditis / therapy
  • Pacemaker, Artificial*
  • Risk Assessment
  • Severity of Illness Index
  • Syncope / diagnosis
  • Syncope / etiology
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents