{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:33:21Z","timestamp":1785411201849,"version":"3.56.0"},"reference-count":8,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["US Cardiol"],"abstract":"<jats:p>Lyme carditis is an uncommon manifestation of disseminated Lyme disease, most frequently presenting as fluctuating atrioventricular block (AVB). We report the case of a middle-aged man with history of frequent deer hunting in a Lyme-endemic region who presented with fatigue and malaise. Skin examination revealed erythema migrans, and the patient had electrocardiographic findings of atrial flutter with high-degree AVB, along with long sinus pauses on telemetry. IV ceftriaxone was started, and subsequent serologic testing confirmed Borrelia burgdorferi infection. Despite appropriate antibiotic therapy, AVB persisted, necessitating permanent pacemaker implantation. This case highlights the importance of early recognition of Lyme carditis, the need for continued cardiac monitoring, and the occasional need for permanent pacemaker implantation in some patients.<\/jats:p>","DOI":"10.15420\/usc.2025.09","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T18:06:42Z","timestamp":1772734002000},"source":"Crossref","is-referenced-by-count":0,"title":["High-grade Atrioventricular Block Due to Disseminated Lyme Disease Requiring Permanent Pacemaker Implantation"],"prefix":"10.15420","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-1550","authenticated-orcid":false,"given":"Vivek","family":"Bhat","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040kfrw16","id-type":"ROR","asserted-by":"publisher"}],"name":"SUNY Upstate Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fretz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02ets8c94","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Shideler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0080-1660","authenticated-orcid":false,"given":"Ankur","family":"Kalra","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/040kfrw16","id-type":"ROR","asserted-by":"publisher"}],"name":"SUNY Upstate Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref0","unstructured":"Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology: 2020 Guidelines for the prevention, diagnosis and treatment of Lyme disease. Neurology 2021;96:262\u201373. https:\/\/doi.org\/10.1212\/wnl.0000000000011151; PMID:\u00a033257476."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Forrester JD, Mead P. Third-degree heart block associated with Lyme carditis: review of published cases. Clin Infect Dis 2014;59:996\u20131000. https:\/\/doi.org\/10.1093\/cid\/ciu411; PMID:\u00a024879781.","DOI":"10.1093\/cid\/ciu411"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Yeung C, Baranchuk A. Diagnosis and treatment of Lyme carditis: JACC review topic of the week. J Am Coll Cardiol 2019;73:717\u201326. https:\/\/doi.org\/10.1016\/j.jacc.2018.11.035; PMID:\u00a030765038.","DOI":"10.1016\/j.jacc.2018.11.035"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Khetpal V, Wark TW, Masel R, et al. A 34-year-old woman with third-degree heart block and atrial flutter associated with Lyme carditis: a case report. Am J Case Rep 2021;22:e933789. https:\/\/doi.org\/10.12659\/AJCR.933789; PMID:\u00a034593747.","DOI":"10.12659\/AJCR.933789"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Oktay AA, Dibs SR, Friedman H. Sinus pause in association with Lyme carditis. Tex Heart Inst J 2015;42:248\u201350. https:\/\/doi.org\/10.14503\/THIJ-14-4126; PMID:\u00a026175640.","DOI":"10.14503\/THIJ-14-4126"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Besant G, Wan D, Yeung C, et al. Suspicious index in Lyme carditis: systematic review and proposed new risk score. Clin Cardiol 2018;41:1611\u20136. https:\/\/doi.org\/10.1002\/clc.23102; PMID:\u00a030350436.","DOI":"10.1002\/clc.23102"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Avellan S, Mehlig K, Robertson J, Bremell D. Incidence of Lyme carditis and Lyme carditis as a cause of pacemaker implantation: a nationwide registry-based case-control study. Open Forum Infect Dis 2023;11:ofad656. https:\/\/doi.org\/10.1093\/ofid\/ofad656; PMID:\u00a038379563.","DOI":"10.1093\/ofid\/ofad656"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Wamboldt R, Wang CN, Miller JC, et al. Pacemaker explantation in patients with Lyme carditis. JACC Case Rep 2022;4:613\u20136. https:\/\/doi.org\/10.1016\/j.jaccas.2022.02.012; PMID:\u00a035615211.","DOI":"10.1016\/j.jaccas.2022.02.012"}],"container-title":["US Cardiology Review"],"original-title":[],"link":[{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2025.09","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T18:06:43Z","timestamp":1772734003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2025.09"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":8,"URL":"https:\/\/doi.org\/10.15420\/usc.2025.09","relation":{},"ISSN":["1758-3896","1758-390X"],"issn-type":[{"value":"1758-3896","type":"print"},{"value":"1758-390X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"article-number":"e03"}}