title: Emergent pacemaker placement in a patient with Lyme carditis-induced complete heart block and ventricular asystole.
abstract: We report a case of a 31-year-old man who presented to the emergency department after four episodes of syncope within a 24 h time span. He was found to have symptomatic complete heart block associated with episodes of ventricular asystole lasting 5-6 s. He underwent emergent permanent pacemaker insertion during which he was found to have no underlying rhythm. He was later found to have positive serologies for Lyme disease despite no known exposure to ticks and neither signs nor symptoms of the disease. The pacemaker was ultimately removed due to resolution of his heart block with antibiotic therapy.
authors.affiliation: Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Brownstein
authors.affiliation: Department of Internal Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.
authors.forename: Samir
authors.identifier: http://orcid.org/0000-0002-9443-164X
authors.initials: S
authors.lastname: Gautam
authors.affiliation: VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA Section of Cardiovascular Medicine, Division of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Paras
authors.initials: P
authors.lastname: Bhatt
authors.affiliation: Department of Internal Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Nanna
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D054537:Atrioventricular Block / Q000150:complications / Q000209:etiology / Q000628:therapy*; D020878:Device Removal; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis*; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000382:microbiology; D010138:Pacemaker, Artificial; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents