Key result
A systematic approach to diagnosing Lyme carditis in patients with high-degree atrioventricular block facilitates identification and prevents unnecessary permanent pacemaker implantation.
Why the study?
Lyme disease is dramatically increasing in North America, and a systematic approach to diagnosing Lyme carditis is needed to identify this transient condition and prevent unnecessary permanent pacemaker implantation.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The bacteria gets into your blood through the tick bite of specific ticks that are endemic in our region, Kingston. Then, once that happens, a process called early dissemination starts, which is within the first 30 to 60 days, that bacteria has a preference to go to certain organs. When the bacteria goes to the heart, we call it Lyme Carditis.”
“There's a chance they may need just a few weeks of antibiotics for it to resolve.”
“Guidelines recommend simultaneous initiation of empirical antibiotic therapy and Lyme serologic testing when Lyme carditis is suspected. Lyme carditis can progress rapidly, and waiting for confirmatory diagnostic therapy to initiate antibiotic treatment may result in negative outcomes.”
May support antibiotics and ECG monitoring in Lyme carditis; hypothesis-generating and requires larger confirmatory trials.
The incidence of Lyme disease, a tick-borne bacterial infection, is dramatically increasing in North America. The diagnosis of Lyme carditis (LC), an early disseminated manifestation of Lyme disease, has important implications for patient management and preventing further extracutaneous complications. High-degree atrioventricular block is the most common presentation of LC, and usually resolves with antibiotic therapy. A systematic approach to the diagnosis of LC in patients with high-degree atrioventricular block will facilitate the identification of this usually transient condition, thus preventing unnecessary implantation of permanent pacemakers in otherwise healthy young individuals.
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Yeung et al. (2019) conducted a review in Lyme carditis. Systematic approach to diagnosis and antibiotic therapy was evaluated. A systematic approach to diagnosing Lyme carditis in patients with high-degree atrioventricular block facilitates identification and prevents unnecessary permanent pacemaker implantation.
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