Abstract
A 23-year-old male presented with dizziness and weakness and reported travel to a tick-prevalent region 1 month prior. Initial electrocardiogram showed a high-grade atrioventricular block with narrow-complex escape rhythm, which progressed to a complete heart block with a wide-complex escape the next day. Resolution of the heart block was documented at follow-up after treatment with appropriate antibiotic therapy. Heart block in Lyme carditis is more commonly reported to be supra-Hisian, manifesting as a narrow-complex escape rhythm. Infra-Hisian block is rare, which manifests as a wide-complex escape rhythm, and may occasionally require permanent pacemaker implantation.
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