Key result
Oral doxycycline resolves Lyme carditis presenting with aborted cardiac arrest and transient atrial fibrillation.
Why the study?
Lyme carditis is typically characterized by atrioventricular conduction abnormalities, but myocardial involvement with preserved AV conduction and electrical instability is less recognized and may delay diagnosis.
Case Report (n=1)
No
Lyme carditis can manifest as severe electrical instability, including cardiac arrest and atrial fibrillation, secondary to myocardial inflammation even when atrioventricular conduction is completely preserved.
Lyme carditis may trigger ventricular arrest or AF despite normal AV conduction; extends recognized spectrum but leaves open broader screening needs.
Lyme disease may involve the heart during early dissemination and most commonly produces atrioventricular (AV) conduction abnormalities. PR interval prolongation, therefore, frequently guides clinical suspicion and management. We describe a previously healthy man who presented with seizure‐like activity, aborted cardiac arrest, transient atrial fibrillation, and cardiac magnetic resonance findings consistent with acute myocarditis, although AV conduction remained normal. Serologic testing subsequently confirmed Lyme carditis. The patient recovered completely with oral doxycycline. This case illustrates that electrical instability may occur despite preserved PR intervals and reinforces the need for suspicion in patients with compatible systemic features.
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Anthony et al. (2026) conducted a case report in Lyme carditis (n=1). Doxycycline was evaluated. Oral doxycycline successfully treated a case of Lyme carditis manifesting as aborted cardiac arrest and transient atrial fibrillation with preserved atrioventricular conduction.
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