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Intra-hisian 2:1 atrioventricular block secondary to Lyme disease
M J Rey1, M Zimmermann, R Adamec
1Cardiology Center, University Hospital, Geneva, Switzerland.
European Heart Journal
|September 1, 1991
Insights
Lyme carditis can cause rare atrioventricular (AV) block at the His bundle level. Prompt treatment with intravenous ceftriaxone restored normal heart rhythm in this case.
Area of Science:
- Cardiology
- Infectious Diseases
- Electrophysiology
Background:
- Lyme carditis is a cardiac manifestation of Lyme disease, often presenting with atrioventricular (AV) block.
- High-grade AV block typically involves the AV node or His-Purkinje system.
Observation:
- This report details a unique case of Lyme carditis presenting with intra-Hisian 2:1 atrioventricular (AV) block.
- Electrophysiological study confirmed the block's location specifically within the His bundle.
Findings:
- The patient experienced a rare form of AV block at the His bundle level, a finding documented in only two previous cases.
- Intravenous ceftriaxone treatment for 4 days led to the restoration of normal sinus rhythm.
Implications:
- This case expands the understanding of the spectrum of AV block in Lyme carditis.
- Highlights the importance of electrophysiological studies in localizing the site of block for accurate diagnosis and management.
- Suggests that timely antibiotic therapy can effectively reverse even complex conduction abnormalities caused by Lyme carditis.
Abstract:
We describe a case of Lyme carditis with intra-hisian 2:1 atrioventricular (AV) block documented by electrophysiological study. To our knowledge, only two cases of AV block at the level of the His bundle has been described in the literature. Sinus rhythm was restored after 4 days of i.v. ceftriaxone.