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Author Spotlight: Expanding the Scope of Multiplex Immunoassays for Lyme Borreliosis Diagnostics and Pathogen Research
Published on: July 14, 2023
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Risk of cardiac conduction disorders, and pacemaker implantations among individuals tested for serum Borrelia
Malte M Tetens1, Lars Haukali Omland1, Ram B Dessau2
1Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Summary
Borrelia burgdorferi (Bb) antibody testing is linked to increased risks of atrioventricular block and conduction disorders. However, Bb seropositivity itself does not appear to cause long-term cardiac conduction issues beyond atrioventricular block.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Borrelia burgdorferi (Bb) infection, or Lyme disease, can manifest with cardiac involvement.
- Cardiac conduction disorders, such as atrioventricular block, are potential complications.
- Understanding the risks associated with Bb testing and seropositivity is crucial for accurate diagnosis and patient management.
Purpose of the Study:
- To assess the short- and long-term risks of atrioventricular block and other cardiac conduction disorders.
- To differentiate risks associated with the diagnostic process (Bb antibody testing) versus actual Bb infection (seropositivity).
- To investigate potential confounding by indication in studies of Bb and cardiac outcomes.
Main Methods:
- Nationwide population-based matched cohort study in Denmark (1993-2021).
- Inclusion of 52,200 Bb-seropositive individuals, 104,400 Bb-seronegative individuals, and 261,000 population controls.
- Analysis of risks for atrioventricular block and other conduction disorders, comparing individuals tested for Bb antibodies and those who are Bb seropositive, with adjustment for relevant covariates.
Main Results:
- Individuals tested for Bb antibodies showed significantly increased short- and long-term risks of atrioventricular block and other conduction disorders compared to population controls.
- Bb-seropositive individuals with both IgM and IgG antibodies had a higher short-term risk of atrioventricular block compared to Bb-seronegative individuals.
- No association was found between Bb seropositivity and increased long-term risk of conduction disorders other than atrioventricular block.
Conclusions:
- The findings suggest that Bb antibody testing is frequently part of the diagnostic work-up for patients presenting with conduction disorders.
- Bb seropositivity alone is not associated with an increased long-term risk of cardiac conduction disorders beyond atrioventricular block.
- The diagnostic process of Bb testing, rather than the infection itself, may contribute to observed short-term risks of conduction abnormalities.
