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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Incidence of carditis and predictors of pacemaker implantation in patients hospitalized with Lyme disease

Uwajachukwumma A Uzomah1, Guy Rozen1, Seyed Mohammadreza Hosseini1

  • 1Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, Boston, MA, United States of America.

Plos One
|November 3, 2021
PubMed

Insights

Approximately 11% of Lyme disease hospitalizations involve carditis, often affecting cardiac conduction. This study found 1% of all Lyme hospitalizations and 11% with conduction issues required permanent pacemakers, with older age and heart block as key predictors.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Lyme carditis, a direct cardiac infection by Borrelia bacteria, affects up to 10% of Lyme disease patients.
  • Cardiac conduction system disease is the most common manifestation of Lyme carditis.
  • Understanding pacemaker implantation incidence and predictors in Lyme carditis is crucial.

Purpose of the Study:

  • To determine the incidence of permanent pacemaker implantation in patients hospitalized with Lyme disease.
  • To identify predictors associated with permanent pacemaker implantation in this population.

Main Methods:

  • Retrospective cohort analysis of the Nationwide Inpatient Sample (2003-2014).
  • Defined Lyme carditis as hospitalization with Lyme disease and cardiac conduction disease, myocarditis, or pericarditis.
  • Excluded patients with pre-existing pacemaker implants; primary outcome was permanent pacemaker implantation.

Main Results:

  • 11% of 96,140 hospitalized Lyme disease patients had Lyme carditis.
  • Permanent pacemaker implantation occurred in 1% of all Lyme hospitalizations and 11% of those with Lyme carditis-associated conduction system disease.
  • Predictors for pacemaker implantation included older age, complete heart block, and sinoatrial node dysfunction.

Conclusions:

  • Lyme carditis affects approximately 11% of hospitalized Lyme disease patients, predominantly causing cardiac conduction issues.
  • Permanent pacemaker implantation was necessary for 1% of all hospitalized Lyme patients and 11% with Lyme-associated conduction disease.
  • Older age and specific conduction abnormalities predict the need for pacemakers in Lyme carditis.
Abstract

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