Lyme Carditis: A Case Report of Unresolved Heart Block

Shannon Baron, et al., published, “Unresolved Heart Block in Lyme Carditis: A Case Report” in Cureus on September 27, 2022, chronicling the case of a man who was admitted to the emergency department with a day-long history of syncopal episodes.

The patient, who was in his thirties, had complete heart block and multiple long and symptomatic pauses in telemetry while under medical supervision. The lengthiest pause was measured at 30 seconds. The patient had a history of repeated occupational exposure to ticks and testing showed positive immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies for Lyme disease.

IV antibiotics were administered, and the patient underwent an urgent temporary transvenous pacemaker placement after which atrioventricular (AV) conduction failed to improve. The patient could not be weaned from the temporary pacemaker, and due to unsuccessful results after the administration of IV antibiotics, a permanent pacemaker was placed.

This case demonstrated that IV antibiotics may be unsuccessful in improving atrioventricular conduction. Some patients may require immediate pacemaker support with a transvenous pacemaker in addition to IV ceftriaxone and followed by permanent pacemaker placement.

For more information:

Read the case report in Cureus.

Read more about Lyme carditis.

Learn more about cardiac manifestations of Lyme & TBD.