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Updated: Mar 11, 2026

Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
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Lyme Arrhythmia in an Avid Golfer: A Diagnostic Challenge and a Therapeutic Dilemma

Ujjwal Rastogi1, Nidhi Kumars1

  • 1James J. Peter VA Medical Center/The Mount Sinai Hospital.

Journal of Atrial Fibrillation
|December 3, 2016
PubMed

Insights

Lyme disease can cause serious heart problems, including heart block. Prompt antibiotic treatment with Ceftriaxone effectively resolved cardiac arrhythmias in a cardiologist with Lyme-induced heart block.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Lyme disease is a tick-borne illness affecting multiple systems.
  • Cardiac involvement in Lyme disease occurs in approximately 5% of cases, primarily affecting the cardiac conduction system.
  • Myopericarditis, though less common, presents diagnostic and therapeutic challenges.

Observation:

  • A 68-year-old male cardiologist presented with exertional dyspnea and palpitations.
  • Electrocardiograms showed intermittent Wenckebach (AV block) with a prolonged PR interval (290-350ms).
  • A transient episode of atrial fibrillation/flutter with AV block was also noted.

Findings:

  • Intravenous Ceftriaxone treatment led to rapid resolution of cardiac arrhythmias.
  • Within 48 hours, the patient's PR interval shortened to 230ms.
  • The patient was discharged on oral Doxycycline for a three-week course.

Implications:

  • This case highlights the importance of considering Lyme disease in patients with unexplained cardiac conduction abnormalities.
  • Early antibiotic intervention is crucial for managing Lyme carditis.
  • Prompt diagnosis and treatment can prevent severe cardiac complications.

Keywords:
ArrhythmiaCardiologistElectrocardiogramsTherapeutic Dilemma

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