posted
I rently had a heart rate as low as 28 BPM. I had undiagnosed Lyme for over 20 years, with in part, a decreasing heart rate. I was diagnosed with Lyme 8 months ago, had 6 weeks of Rocephin, and continued with shortness of breath, dizziness, and a pulse from high 20's to low 30's. Although I am much better after treatment in many other areas, a pacemaker had to be installed and breathing was restored to normal, dizziness improved and my heart rate is now in the 60's constantly. Has anyone heard of this before as being directly related to Lyme Disease, Thanks.
Posts: 43 | From Suffolk County | Registered: Mar 2007
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quote:Originally posted by Kings Park: I was diagnosed with Lyme 8 months ago, had 6 weeks of Rocephin,...
Why didn't you ask about this BEFORE the pacemaker was put in?
On the other hand, now you won't have to worry about one of the uglier side effects of Zithro: Q-T prolongation (the heart thumpies) if your LLMD should want to prescribe it. So maybe it will turn out to be a good thing.
I have been a cardiologist for more than 20 years and find that the practice of cardiology may have become routine. The massive burden of ischaemic heart disease sometimes obscures the clinical and epidemiological traps that lay in our paths once in a while. The 47-year-old consultant of our neonatology department experienced vague chest sensations accompanied by cough. Palpating his pulse he noticed extrasystoles. During a transatlantic flight 1 month later, after a short moment of discomfort in the right shoulder he experienced some lightheadedness and blurred vision when he went to the lavatory. He returned immediately to his seat where he collapsed and had a seizure, which was noticed by a fellow passenger. Shortly thereafter, all the symptoms ceased and he fully recovered.
He left the plane independently and was admitted to our department. His ECG was normal, except for first-degree atrioventricular block. He was observed on our cardiology ward, where no significant bradyarrhythmias were seen. A 24 h Holter recording did not show any abnormalities, except for persistent first-degree atrioventricular block. Left heart catheterisation and coronary angiography were normal. Invasive electrophysiology testing revealed a prolonged sinus node recovery time, an atrioventricular node refractory period of over 400 msec (normal less than 300 msec) and the occurrence of Wenckebach block at a paced heart rate of 110 beats per minute. A DDD pacemaker was inserted and the patient did not experience recurrent syncope.
The patient consulted the medical literature on the causes of atrioventricular conduction disturbances and had his serum tested for antibodies to Borrelia burgdorferi in the blood samples taken at hospital admission. They showed a strong IgM antibody response.
Clearly, his symptoms and conduction disturbances were due to Lyme disease. He was treated with doxycycline and the atrioventricular block disappeared on follow-up ECGs. He had received his pacemaker for atrioventricular block due to Lyme disease.
It is not the first time that patients themselves made their correct diagnosis. Even physician patients do so, but for me this is the first time that in a group of over 20 physicians during a morning report session, where the ECG's of this 47 year old man with atrioventricular block were shown, nobody suggested a possible diagnosis of Lyme disease. As their chief I fully took the responsibility. I talked to my colleague and explained that at a later age his pacemaker may be of value. Clinical errors influence the evolution of careers of many physicians. A diagnosis missed by a group of doctors will be of use for the whole group. On the other hand, discussing cases in large groups of doctors does not guarantee a correct diagnosis of a common disease leading to a common conduction disturbance treated inappropriately with a common device.
University Medical Center St Radboud, Nijmegen, Netherlands
-------------------- Sassy Posts: 12 | From TX | Registered: Oct 2007
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posted
Kings Park....Are you currently in treatment for Lyme??
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
Pacemakers mentioned- Pumed citations (not all of them, just some) for Lyme & pacemaker-
*********************** 1: Can J Cardiol. 1995 Apr;11(4):335-8.Links
Lyme carditis: indications for cardiac pacing.
Nagi KS, Thakur RK. Arrhythmia Service, University Hospital, London, Ontario.
Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. It is the most common reported vector-borne illness in the United States. The clinical course of Lyme disease is divided into early and late phases. Early disease may be limited or disseminated. Generally, cardiac complications occur in the early disseminated phase.
Disturbance of atrioventricular conduction is the most commonly recognized cardiac manifestation of Lyme disease. This is usually self-limited and does not require permanent cardiac pacing.
A case of Lyme carditis with atrioventricular block requiring permanent pacing is reported and the indications for cardiac pacing in this disease are reviewed.
PMID: 7728646
1: Hellenic J Cardiol. 2006 Sep-Oct;47(5):313-6.Links Lyme carditis: complete atrioventricular dissociation with need for temporary pacing.Xanthos T, Lelovas P, Kantsos H, Dontas I, Perrea D, Kouskouni E. Department of Experimental Surgery and Surgical Research, Aretaieion Hospital, University of Athens Medical School, Greece. [email protected]
Lyme borreliosis is a tick-borne disease. Cardiac manifestations of the disease are extremely rare. We report a case of Lyme carditis in an otherwise healthy male, who presented to the Accident & Emergency Department with chest pain, dizziness and generally symptoms indicating ischaemic heart disease. This patient, without documented history of Lyme disease, acutely developed third-degree atrioventricular block, which required placement of a transvenous pacemaker and resolved when the patient was administered doxycycline.
PMID: 17134068
1: Ugeskr Laeger. 1993 Jul 5;155(27):2147-50.
Serious arrhythmias in Borrelia infections
Midttun M, Videbaek J.Hjertemedicinsk afdeling Y, Bispebjerg Hospital, K�benhavn.
Carditis is seen in about 4-10% of cases of Lyme's disease. It is usually dominated by varying degrees of atrioventricular block, and implantation of a temporary pacemaker may be necessary. Ventricular and supraventricular tachycardias seem to be less frequent than block, and as far as we know ventricular tachycardia provoked by bradycardia has not been reported previously. Third degree AV-block after oral penicillin treatment of erythema migrans is unusual in Europe. When an atrioventricular block of unknown origin is diagnosed, Lyme carditis must be considered, especially among young patients.
PMID: 8328068
1: Z Kardiol. 2003 Dec;92(12):1029-32. Links
Lyme carditis and symptomatic sinus node dysfunction
Franck H, Wollschl�ger H. I. Medizinische Klinik, Klinikum St. Marien, Mariahilfbergweg 5-7, 92224 Amberg, Germany.
Lyme carditis is typically associated with AV nodal conduction abnormalities. We describe the case of a 66 year old female patient, who experienced a series of syncopal attacks after several tick bites two weeks earlier. ECG monitoring revealed recurrent sinus arrest with a maximum pause duration of 8 seconds. After institution of antibiotic therapy for Lyme carditis, sinus node dysfunction resolved rapidly and the patient had no further syncopes. Pacemaker implantation was not necessary. We therefore have to assume that in this patient Lyme carditis was the cause of symptomatic sinus node dysfunction.
PMID: 14663614
1: Wien Klin Wochenschr. 1999 Dec 10;111(22-23):964-9.Links
Borrelia burgdorferi as a cause of Morgagni-Adams-Stokes syndrome. Long time follow-up study.
Bartunek P, Mr�zek V, Varejka P, Gorican K, Zapletalov� J, Sklen�r T. IVth Department of Internal Medicine, Charles University, Prague, Czech Republic. [email protected]
According the literature atrio-ventricular blockade (AVB) is the most frequent and well-known symptom of Lyme carditis. Typical signs of complete AVB include fatigue, lethargy and syncope- Morgagni-Adams-Stokes syndrome (MAS). The authors present their results and experience with 5 patients selected from a long-term study (conducted between 1987 and 1998) comprising 58 patients who developed MAS. The authors tried to evaluate the changes especially in the cardiovascular system. They correlated the clinical state with ECG findings, as well as with the levels of the Borrelia burgdorferi antibodies. The following results were obtained: 1) all patients had typical syncope, 2) the clinical course was not complicated (except one patient who developed ventricular fibrillation), 3) two patients had frequent symptomatic and asymptomatic arrhythmia including chest pain and episodic rest dyspnea, 4) subjective difficulties (usually palpitations) correlated with ECG findings (Lown 3a, 3b).
The authors also looked for any relationship between clinical difficulties and levels of antibodies.
The results obtained with an early permanent pacemaker were less favourable than those reported in the literature.
Despite early treatment 2 patients had repeated palpitations and ECG correlates during the next years.
PMID: 10666810
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
Here's a story of a guy with Lyme who needed a pacemaker- from Nevada!! His heart was down to 18 beats a minute!!! 36 years old!! ******************************************** http://home.swbell.net/dsny1fan/Nevada.html
June 04, 1998
Rob Hill is one tough guy
By LEWIS FRANCK For The Associated Press
Some athletes play hurt. Champ car crew chief Rob Hill has taken that to another level.
Like Superman, Hill bends steel in his bare hands, a detached pacemaker notwithstanding.
"He doesn't act like an injured crew chief, and sometimes we give him a lot of kidding for what he's doing," said Alex Zanardi, the CART FedEx Championship Series points leader. "I think he should take more care of himself."
Zanardi, also the reigning series champion, won in April in Long Beach, Calif., capping a remarkable comeback after the steering arm of his car was damaged in a collision.
But the crew chief - who doubles as an agile tire chief - came to the rescue, bending a 23-inch steel shaft back into shape.
At the time, Hill was scheduled for surgery to reattach wires to his pacemaker. They had dislodged during a pit stop at the season-opener in March.
Two years earlier, Hill was bitten by a tick while his Target-Chip Ganassi Racing team was testing in Elkhart Lake, Wis. He returned home, celebrated the birthday of his wife, Casey, and went to sleep.
When he awoke in pain, Hill thought it was something he had eaten. Instead, it was Lyme disease.
"My wife was kind of concerned because I must have been looking pretty bad," the Australian-born Hill recalled.
He acted stubbornly at first, refusing help.
"I'm not going to the hospital for food poisoning," he told his wife.
Eventually, he had no choice. When the arrived at the hospital, his condition was not good.
"All of the time, I was sort of conscious of things going on, and I knew there was a panic going on, but I didn't know it was for me," Hill said. "I was expecting to just get an IV and go home."
His heart rate was down to 18 beats per minute, and, "They couldn't believe that I was still conscious."
He wasn't for much longer. He passed out and was hustled toward an emergency room.
"When I came to, it was just like a movie," Hill said. "I was on a gurney and they were just hauling down this corridor and one of the nurses says, 'Stop! Stop! Let his wife kiss him goodbye'
"I remember looking at Casey and thinking, 'Why are you crying? I'm fine.' I don't remember anything until I came to."
The Lyme disease, from the tick bite, had damaged Hill's heart.
"They were reluctant to put a pacemaker in, initially, just because of my age," the 36-year-old Hill said. "If you put one in, the heart's not going to repair itself properly because it's got an auxiliary power source."
But none of the temporary fixes worked. It was difficult for Hill to jump over the pit wall, change tires and watch for traffic with an IV in his arm. So, last October, a pacemaker was installed.
In March, in Homestead, Fla., Zanardi had taken tires and fuel when Hill, who stands at the right front, waved him out. Instantaneously, Hill saw the rapid approach of Mark Blundell - trying to pit in front of Zanardi.
It was time for action. Zanardi had to be stopped.
"I thought, 'This is going to be bad,' so I jumped in the middle of it and I thought I was going to be a sandwich," Hill said.
Like a soldier diving on a hand grenade to protect his buddies, Hill dived in front of Zanardi's 850-horsepower Reynard-Honda, its wheels spinning, about to launch itself out of the pits. The wrenching motion ripped out one of the pacemaker's wires and left the other barely hanging on.
"That was the problem," Hill said. "Older people, they aren't running around, jumping around and getting hit. So they didn't leave the leads enough free room."
Despite being told he would need surgery, Hill went to the next CART race, in Japan, and the following week to Long Beach.
It was at Long Beach that Hill decided it would take too long to change the steering arm. He straddled the car and pounded the arm with his bare hands.
To Zanardi, Hill is like the movie hero who saves the day despite being riddled with bullets.
"The only difference is, this is not a movie." Zanardi said. "This is the truth."
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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