Treating Lyme carditis high-degree AV block using a temporary–permanent pacemaker

Abstract

A 28-year-old previously healthy male presented with nonprodromal syncope and a 4-day history of chest pain, shortness of breath, and malaise. His ECG showed rapidly progressive high-degree AV block. His Suspicious Index in Lyme Carditis (SILC) score was 8, indicating high risk for Lyme carditis. Lyme serology revealed to be positive (anti-Lyme IgM). During the second day of hospitalization, the patient deteriorated his AV conduction, and a temporary–permanent pacemaker was implanted allowing ambulating in hospital the very same day. Temporary–permanent pacemakers for the management of transient high-degree heart block associated with Lyme carditis were only occasionally used in the past.