Persistent bradycardia requiring temporary pacing in a young adult with lyme carditis: a case report

Lyme disease is a common vector-borne infection that can lead to complications such as Lyme carditis (LC), particularly in untreated cases. LC can manifest as conduction abnormalities, including heart block and other arrhythmias, potentially leading to serious cardiac events.

We report a case of a 38-year-old male with no prior medical history presenting with recurrent dizziness and bradycardia. The patient exhibited Erythema Migrans and had a history of a recent tick bite, with Lyme serology confirming the diagnosis. Despite intravenous ceftriaxone, the patient experienced persistent bradycardia and intermittent episodes of ventricular tachycardia, necessitating transvenous pacing. His condition stabilized, and he completed a 28-day antibiotic regimen, leading to full recovery.

This case highlights the importance of recognizing Lyme carditis in endemic areas and the role of temporary pacing in managing symptomatic bradycardia. Early intervention with antibiotics and appropriate supportive measures can facilitate recovery, prevent progression, and reduce the need for permanent pacing.