A 28-year-old previously healthy male presented with nonprodromal syncope and a 4-day history of chest pain, shortness of breath, and malaise. His ECG showed rapidly progressive high-degree AV block. His Suspicious Index in Lyme Carditis (SILC) score was 8, indicating high risk for Lyme carditis. Lyme serology revealed to be positive (anti-Lyme IgM). During the second day of hospitalization, the patient deteriorated his AV conduction, and a temporary-permanent pacemaker was implanted allowing ambulating in hospital the very same day. Temporary-permanent pacemakers for the management of transient high-degree heart block associated with Lyme carditis were only occasionally used in the past.
Keywords: bradyarrhythmias; conduction disturbances; electrophysiology; implantable devices; lead implantation/extraction; pacemaker.
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