[Lyme carditis : an unusual approach to temporary pacing]

Lyme carditis can occur a few weeks/months after the onset of Lyme disease and usually triggers an atrioventricular conduction block of variable degree. We report a 39-year-old man who presented with symptomatic complete atrioventricular block secondary to Lyme carditis. We decided to implant a traditional single chamber pacemaker using an unusual approach: the battery was fixed directly onto the skin. The patient was discharged with ceftriaxone IV during 2 weeks, clinical follow up and pacemaker interrogations twice a week. The complete heart block resolved after 2 weeks. After a normal 3 days ECG and exercise test, the pacemaker was removed without any complications after a total of 3 weeks.