Temporary Pacing in Complete Heart Block due to Lyme Disease: A Case Report

Láng, István; Lakos, András; Kovács, P.; Várvölgyi, Csaba; Polgár, Péter; Wórum, F

doi:10.1111/j.1540-8159.1989.tb05059.x

Cited by 18 publications

(6 citation statements)

References 15 publications

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“…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%

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

Besant

Wan

Yeung

et al. 2018

Clinical Cardiology

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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.

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“…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%

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

Besant

Wan

Yeung

et al. 2018

Clinical Cardiology

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“…Several sporadic cases and small series of patients with Lyme carditis have been reported, predominantly in adults and only rarely in children [14][15][16][17][18][19][20][21][22][23][24][25]. According to published information the heart is usually involved early in the course of illness, i.e.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic findings in children with erythema migrans

Mravljak

Velnar

Bricelj

et al. 2006

Wien Klin Wochenschr

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Electrocardiographic abnormalities in children with erythema migrans are mild, nonspecific and rare. The presence of clinical signs and symptoms indicative or suggestive of disseminated Lyme borreliosis is not associated with higher frequency of such abnormalities. Comparison of findings in patients with erythema migrans and healthy children revealed several distinctions, some of which might have been interpreted as a result of altered activity of the autonomic nervous system.

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“…Such an approach also applies to patients with Lyme disease, presenting with a PQ interval of >300 ms (11). The hospital must be equipped for temporary pacemaker implantation, because in approximately 35% patients with Lyme carditis the progression of the heart block will require temporary ventricular stimulation (12,33). However, patients with high-degree AV block typically recover within one week (16,34).…”

Section: Chronic Coursementioning

confidence: 99%