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Lyme Carditis Causing Polymorphic Ventricular Tachycardia and Cardiogenic Shock.
David T Zhang1, Anthony V Delicce1, Abhijeet Singh1
1Division of Cardiology, Department of Medicine, Stony Brook Medicine, Stony Brook, New York, USA.
JACC. Case Reports
|July 18, 2025
Summary
Lyme carditis can cause complete heart block and life-threatening ventricular arrhythmias. This case details a rare presentation requiring advanced interventions like mechanical support and defibrillator implantation.
Area of Science:
- Cardiology
- Infectious Diseases
- Electrophysiology
Background:
- Lyme carditis typically causes atrioventricular node block.
- Other arrhythmias are rare but possible complications.
Observation:
- A 34-year-old man presented with symptoms of complete heart block (CHB).
- He experienced an episode of polymorphic ventricular tachycardia (PMVT) arrest, requiring extracorporeal membrane oxygenation and temporary pacing.
- Lyme IgM antibodies were positive, and antibiotic treatment was initiated.
Findings:
- Despite antibiotic and antiarrhythmic therapy, PMVT recurred.
- The patient developed severe biventricular failure.
- A subcutaneous implantable cardioverter-defibrillator was ultimately implanted due to recurrent PMVT.
Implications:
- This case highlights a rare, severe presentation of Lyme carditis.
- Polymorphic ventricular tachycardia and cardiogenic shock are rare complications.
- Management involved advanced interventions including mechanical circulatory support and device implantation.
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