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Phage-Mediated Genetic Manipulation of the Lyme Disease Spirochete Borrelia burgdorferi
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Sinus pause in association with Lyme carditis

A Afsin Oktay, Samer R Dibs, Harvey Friedman

    Texas Heart Institute Journal
    |July 16, 2015
    PubMed

    Insights

    Lyme carditis can cause unusual heart rhythm problems, including symptomatic sinus pauses. This case report highlights a rare North American instance of Lyme disease affecting heart conduction after tick exposure.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Electrophysiology

    Background:

    • Lyme disease, caused by Borrelia burgdorferi, is a common tick-borne illness in the US.
    • Cardiac involvement (Lyme carditis) affects 4-10% of patients, typically causing atrioventricular node dysfunction.
    • Other cardiac conduction abnormalities are rare but can include bundle branch block and tachyarrhythmias.

    Observation:

    • A 59-year-old man developed symptomatic sinus pauses.
    • Symptoms emerged one month after hiking in upstate New York.
    • This presentation is unusual for Lyme carditis.

    Findings:

    • The patient's symptomatic sinus pauses were linked to Lyme carditis.
    • This represents the first reported case in North America of Lyme carditis presenting with symptomatic sinus pause.
    • The findings expand the spectrum of known cardiac manifestations of Lyme disease.

    Implications:

    • Clinicians should consider Lyme carditis in patients with unexplained sinus node dysfunction, especially after potential tick exposure.
    • Early diagnosis and treatment of Lyme disease may prevent cardiac complications.
    • Further research is warranted to understand the mechanisms and prevalence of Lyme carditis-induced sinus node dysfunction.

    Keywords:
    Borrelia burgdorferiLyme disease/diagnosisheart block/etiologysinoatrial block/diagnosissinus node dysfunctionsinus pausetick-borne diseases

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