Complete atrio-ventricular block as a first symptom of borreliosis: antibiotic treatment instead of pacemaker implantation

Kaczmarek, Krzysztof; Deroń, Zbigniew; Janiszewski, Tomasz; Supel, Karolina; Ptaszyński, Paweł; Ruta, Jan; Cygankiewicz, Iwona

doi:10.5603/kp.2013.0020

Cited by 5 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another 34 articles were removed for: not in English, not a case report/series, or not reporting high‐degree AVB . The final 74 articles reported on 88 cases relevant to this study ).…”

Section: Resultsmentioning

confidence: 99%

“…Unsurprisingly, SILC successfully identified 93.2% of the total previously published cases as intermediate or high risk of LC. Of all 88 cases, six scored low on the SILC score . All six low‐scoring SILC cases lacked data on at least one of the SILC variables, and five of these lacked data on 3 or more SILC variables .…”

Section: Discussionmentioning

confidence: 99%

“…Of all 88 cases, six scored low on the SILC score . All six low‐scoring SILC cases lacked data on at least one of the SILC variables, and five of these lacked data on 3 or more SILC variables . If all relevant data were available, the low‐scoring SILC cases may have been categorized as higher‐risk on the SILC scale.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17][18][19] All six low-scoring SILC cases lacked data on at least one of the SILC variables, and five of these lacked data on 3 or more SILC variables. [14][15][16][17]19 If all relevant data were available, the low-scoring SILC cases may have been categorized as higher-risk on the SILC scale. This proposed score has not been prospectively validated yet; therefore, before concluding on its value, it would be reasonable to apply SILC to a prospective series.…”

Section: Clinical Course Of Lc Casesmentioning

confidence: 99%

See 3 more Smart Citations

Suspicious index in Lyme carditis: Systematic review and proposed new risk score

Besant

Wan

Yeung

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

Background Lyme carditis (LC), an early manifestation of Lyme disease that most commonly presents as high‐degree atrioventricular block (AVB), usually resolves with antibiotic treatment. When LC is not identified as the cause of AVB, a permanent pacemaker may be inappropriately implanted in a reversible cardiac conduction disorder. Hypothesis The likelihood that a patient's high‐degree AVB is caused by LC can be evaluated by clinical characteristics incorporated into a risk stratification tool. Methods A systematic review of all published cases of LC with high‐degree AVB, and five cases from the authors' experience, was conducted. The results informed the development of a new risk stratification tool, the Suspicious Index in LC (SILC) score. The SILC score was then applied to each case included in the review. Results Of the 88 cases included, 51 (58%) were high‐risk, 31 (35.2%) intermediate‐risk, and 6 (6.8%) low‐risk for LC according to the SILC score (sensitivity 93.2%). For the subset of 32 cases that reported on all SILC variables, 24 (75%) cases were classified as high‐risk, 8 (25%) intermediate‐risk, and 0 low‐risk (sensitivity 100%). Specificity could not be assessed (no control group). Notably, 6 of the 11 patients who received permanent pacemakers had reversal of AVB with antibiotic treatment. Conclusion The SILC risk score and COSTAR mnemonic (constitutional symptoms; outdoor activity; sex = male; tick bite; age < 50; rash = erythema migrans) may help to identify LC in patients presenting with high‐degree AVB, and ultimately, minimize the implantation of unnecessary permanent pacemakers.

show abstract

“…Another 34 articles were removed for: not in English, not a case report/series, or not reporting high‐degree AVB . The final 74 articles reported on 88 cases relevant to this study ).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Course Of Lc Casesmentioning

confidence: 99%

See 2 more Smart Citations

Suspicious index in Lyme carditis: Systematic review and proposed new risk score

Besant

Wan

Yeung

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…It is most often observed in the second stage of the disease [1]. Although both conduction dysfunction and dilated cardiomyopathy might develop years after the pathogen entered the body [17].…”

Section: Lyme Carditis (Lc) Epidemiologymentioning

confidence: 99%

Cardiovascular manifestations of Lyme disease - a literature review

Lubaszka,

Fiega,

Michalska

et al. 2023

J Educ Health Sport

View full text Add to dashboard Cite

Lyme disease is an infectious zoonosis transmitted by ticks infected with Borrelia spirochetes. Condition affects multiple organ systems and typically has a protracted course. Although Lyme carditis is a comparatively rare symptom of Lyme borreliosis, it can cause major cardiac conditions, including death, if left untreated. Atrioventricular block of various degrees is the hallmark of cardiac involvement, although other manifestations of the disease are increasingly describe such as ventricular and supraventricular arrhythmias, pericarditis, acute coronary syndrome, mild heart failure, cardiac tamponade or individual cases of cardiomyopathy, degenerative valvular lesions and vasculitis. Cardiovascular conduction disorders have a good prognosis despite their abrupt onset and completely resolve after a few days of antibiotic therapy. Therefore, a wait-and-see attitude should be maintained. However, a temporary or permanent pacemaker may be required if the patient's clinical condition necessitates prompt intervention. Nevertheless, current recommendations suggest avoiding temporary stimulation wherever possible and limiting its use to the shortest treatment time possible.

show abstract

Associations of Atrioventricular Blocks and Other Arrhythmias in Patients with Lyme Carditis: A Systematic Review and Meta-Analysis

Javed,

Sklyar,

Bella

2024

JCDD

View full text Add to dashboard Cite

Lyme disease often leads to cardiac injury and electrophysiological abnormalities. This study aimed to explore links between atrioventricular blocks and additional arrhythmias in Lyme carditis patients. This systematic review and meta-analysis of existing literature was performed from 1990 to 2023, and aimed to identify cases of Lyme carditis through serology or clinical diagnosis with concomitant arrhythmias. Pubmed and Web of Science were searched using appropriate MESH terms. Patients were divided into groups with atrioventricular blocks and other arrhythmias for cardiovascular (CV) outcome assessment. A total of 110 cases were analyzed. The majority (77.3%) were male, with mean age = 39.65 ± 14.80 years. Most patients presented within one week of symptom onset (30.9%). Men were more likely to have first-degree atrioventricular blocks (OR = 1.36 [95% CI 1.12–3.96], p = 0.01); these blocks tended to be reversible in nature (OR = 1.51 [95% CI 1.39–3.92], p = 0.01). Men exhibited a higher likelihood of experiencing variable arrhythmias (OR = 1.31 [95% CI 1.08–2.16], p < 0.001). Ventricular and supraventricular arrhythmias were more likely to exhibit instability (OR = 0.96 [95% CI 0.81–1.16] p = 0.01) and variability (OR = 1.99 [95% CI 0.47–8.31], p < 0.001). Men with Lyme carditis are likely to present with various atrioventricular blocks. These atrioventricular blocks are benign, and follow a predictable and stable clinical course. Further large-scale studies are warranted to confirm these associations.

show abstract

Complete atrio-ventricular block as a first symptom of borreliosis: antibiotic treatment instead of pacemaker implantation

Cited by 5 publications

References 6 publications

Suspicious index in Lyme carditis: Systematic review and proposed new risk score

Suspicious index in Lyme carditis: Systematic review and proposed new risk score

Cardiovascular manifestations of Lyme disease - a literature review

Associations of Atrioventricular Blocks and Other Arrhythmias in Patients with Lyme Carditis: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About