Prevalence of Lyme Carditis in Patients with Atrioventricular Blocks

Krzysztof A. Kaczmarek (), Katarzyna Szwabe, Irmina Urbanek, Pawel Ptaszynski, Aleksander Strzelecki, Jerzy K. Wranicz and Iwona Cygankiewicz
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Krzysztof A. Kaczmarek: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland
Katarzyna Szwabe: Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, 90-647 Lodz, Poland
Irmina Urbanek: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland
Pawel Ptaszynski: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland
Aleksander Strzelecki: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland
Jerzy K. Wranicz: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland
Iwona Cygankiewicz: Department of Electrocardiology, Central University Hospital, Medical University of Lodz, 90-647 Lodz, Poland

IJERPH, 2022, vol. 19, issue 22, 1-11

Abstract: Infections with Borrelia may cause cardiac conduction system abnormalities, including atrioventricular blocks (AVBs). Therefore, we aimed to identify patients in whom Lyme carditis (LC) could be considered as the initial diagnosis among consecutive subjects who were referred for implantation of a permanent pacemaker due to symptomatic AVBs. To date, such a systematic evaluation has not been reported yet. Validation of the Suspicious Index for Lyme Carditis (SILC) in our study population was considered as an additional goal. We investigated consecutive patients with AVB admitted to our department for a pacemaker implantation. Serological diagnostic tests against Borrelia burgdorferi sensu lato (Bbsl) were performed in those with no obvious cardiac causes of AVB. The final study population consisted of 130 patients (80 M, mean age 67.4 ± 17.6). Lyme carditis was assumed as the initial diagnosis in 16 patients (12%) based on ABV and IgM Bbsl seropositivity. The patients with LC were younger and more frequently manifested constitutional symptoms of infection and fluctuating AVB. The highest prognostic value for identification of LC patients was obtained for the modified SILC, which included the following parameters: (1) age lower than 75 years; (2) risky outdoor activity and living in the countryside; (3) tick bite; (4) constitutional symptoms of Lyme disease; (5) erythema migrans; (6) male sex and (7) fluctuating atrioventricular block. We concluded that diagnostics for LC should be routinely considered in patients with advanced AVB. Modified SILC may identify the patients at risk of LC.

Keywords: atrioventricular block; Borrelia burgdorferi; Lyme carditis; pacemaker (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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