Lyme disease and arrhythmias

Abstract

Infections with spirochetes (Borelia burgdoferi) occur through contact with ticks (Ixodes ricinus) found in forests, meadows, lawns, in bushes, most often from May to September. The risk of developing Lyme disease after a single tick bite does not exceed 1%. Clinically overt disease develops usually after 0.3-1.4% bites. Lyme disease may affect many organs and is chronic. Symptoms may include skin, eyes, nervous, musculoskeletal, cardiovascular, digestive and urogenital system. Cardiovascular system involvement occurs, according to va­rious reports, in 0.5 to 10% of cases. Men are sick more often than women, young patients predominate, < 50 years old. The clinical onset is acute and atrioventricular conduction disturbances are most commonly diagnosed (80-90% of cases). Atrioventricular blocks: first (>70%), second (30%) and third (70%) degree may occur. There are also descriptions of cardiac arrhythmias – both supraventricular and ventricular – as well as cases of prolonged QT interval, especially in children. Identification of patients who are more likely to have a third degree atrioventricular block in Lyme disease is critical to ensure timely and appropriate treatment. In most patients, antibiotic treatment helps to avoid the use of permanent cardiac pacing, but 20-50% of patients may need temporary pacing. In patients quickly, correctly diagnosed and treated – the prognosis is good.