scholarly journals A Case of Lyme Carditis Presenting with Atrial Fibrillation

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Peter J. Kennel ◽  
Melvin Parasram ◽  
Daniel Lu ◽  
Diane Zisa ◽  
Samuel Chung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Borrelia Burgdorferi ◽  
Antibiotic Therapy ◽  
Unusual Presentation ◽  
Type I ◽  
Atrial Arrhythmias ◽  
Av Block ◽  
Lyme Carditis ◽  
Second Degree

We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi. After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis.

Atrioventricular conduction abnormalities and atrioventricular blocks: ECG patterns and diagnosis

2018 ◽  
Author(s):  
S. Serge Barold
Keyword(s):  
P Wave ◽  
Conduction Time ◽  
Type I ◽  
Type Ii ◽  
Av Block ◽  
Ventricular Extrasystoles ◽  
Av Conduction ◽  
Pr Interval ◽  
Before And After ◽  
Second Degree

The diagnosis of first-degree and third-degree atrioventricular (AV) block is straightforward but that of second-degree AV block is more involved. Type I block and type II second-degree AV block are electrocardiographic patterns that refer to the behaviour of the PR intervals (in sinus rhythm) in sequences (with at least two consecutive conducted PR intervals) where a single P wave fails to conduct to the ventricles. Type I second-degree AV block describes visible, differing, and generally decremental AV conduction. Type II second-degree AV block describes what appears to be an all-or-none conduction without visible changes in the AV conduction time before and after the blocked impulse. The diagnosis of type II block requires a stable sinus rate, an important criterion because a vagal surge (generally benign) can cause simultaneous sinus slowing and AV nodal block, which can resemble type II block. The diagnosis of type II block cannot be established if the first post-block P wave is followed by a shortened PR interval or by an undiscernible P wave. A narrow QRS type I block is almost always AV nodal, whereas a type I block with bundle branch block barring acute myocardial infarction is infranodal in 60–70% of cases. All correctly defined type II blocks are infranodal. A 2:1 AV block cannot be classified in terms of type I or type II block, but it can be AV nodal or infranodal. Concealed His bundle or ventricular extrasystoles may mimic both type I or type II block (pseudo-AV block), or both

Type I Second-Degree AV Block (Mobitz Type I, Wenckebach AV Block) During Ritrodrine Therapy for Preterm Labor

1991 ◽  
Vol 8 (02) ◽  
pp. 150-152 ◽  
Author(s):  
David Sherer ◽  
Mark Nawrocki ◽  
Howard Thompson ◽  
James Woods
Keyword(s):  
Preterm Labor ◽  
Type I ◽  
Av Block ◽  
Mobitz Type ◽  
Second Degree

Atrioventricular conduction abnormalities and atrioventricular blocks: ECG patterns and diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1958-1961
Author(s):  
S. Serge Barold
Keyword(s):  
P Wave ◽  
Conduction Time ◽  
Type I ◽  
Type Ii ◽  
Av Block ◽  
Ventricular Extrasystoles ◽  
Av Conduction ◽  
Pr Interval ◽  
Before And After ◽  
Second Degree

The diagnosis of first-degree and third-degree atrioventricular (AV) block is straightforward but that of second-degree AV block is more involved. Type I block and type II second-degree AV block are electrocardiographic patterns that refer to the behaviour of the PR intervals (in sinus rhythm) in sequences (with at least two consecutive conducted PR intervals) where a single P wave fails to conduct to the ventricles. Type I second-degree AV block describes visible, differing, and generally decremental AV conduction. Type II second-degree AV block describes what appears to be an all-or-none conduction without visible changes in the AV conduction time before and after the blocked impulse. The diagnosis of type II block requires a stable sinus rate, an important criterion because a vagal surge (generally benign) can cause simultaneous sinus slowing and AV nodal block, which can resemble type II block. The diagnosis of type II block cannot be established if the first post-block P wave is followed by a shortened PR interval or by an undiscernible P wave. A narrow QRS type I block is almost always AV nodal, whereas a type I block with bundle branch block barring acute myocardial infarction is infranodal in 60–70% of cases. All correctly defined type II blocks are infranodal. A 2:1 AV block cannot be classified in terms of type I or type II block, but it can be AV nodal or infranodal. Concealed His bundle or ventricular extrasystoles may mimic both type I or type II block (pseudo-AV block), or both

scholarly journals Type I Wenckebach second-degree AV block: A matter of definition

2018 ◽  
Vol 41 (3) ◽  
pp. 282-284
Author(s):  
S. Serge Barold
Keyword(s):  
Type I ◽  
Av Block ◽  
Second Degree

scholarly journals Lyme Carditis: A Case Report and Review of Management

2018 ◽  
Vol 53 (4) ◽  
pp. 263-265 ◽  
Author(s):  
Sheheryar Muhammad ◽  
Robert J. Simonelli
Keyword(s):  
Heart Rate ◽  
Case Report ◽  
Erythema Migrans ◽  
Acute Onset ◽  
Unknown Etiology ◽  
Type I ◽  
Av Block ◽  
Presumptive Diagnosis ◽  
Lyme Carditis ◽  
Mobitz Type

Purpose: A case report of a patient who presented with an acute onset, fluctuating atrioventricular (AV) block and was diagnosed with Lyme carditis is presented. Summary: A 55-year-old man with progressively worsening generalized malaise, flu-like symptoms, dyspnea on exertion, and near syncope was admitted with bradycardia (heart rate was between 20 and 30 beats per minute upon admission). He endorsed having several tick bites after which he developed erythema migrans on his arm and abdomen. An electrocardiogram (ECG) revealed a second-degree AV block, fluctuating between Mobitz type I and Mobitz type II heart block, with a P-R interval of 300 ms. A presumptive diagnosis of Lyme carditis was made based on a confirmed history of tick exposure, presence of erythema migrans, and AV block. The patient was started on ceftriaxone. On day 3 of hospitalization, patient’s heart rate was between 50 and 60 beats per minute. A diagnosis of Lyme disease was confirmed based on serologic testing. A repeat ECG revealed a first-degree AV block with a P-R interval of 300 ms. On day 5 of hospitalization, a peripherally inserted central catheter line was placed and the patient was discharged to his home on a 28-day course of ceftriaxone. Patient’s heart rate was 65 beats per minute on discharge day. Conclusion: Considering Lyme carditis as a differential diagnosis in patients with an AV block of an unknown etiology can result in a timely diagnosis and treatment of Lyme carditis.

Een sportieve vijftiger met brutale syncope ten gevolge van Lyme carditis

2021 ◽  
Author(s):  
C. BAESTAENS ◽  
S. HELLEMANS
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Antibiotic Therapy ◽  
Medical History ◽  
Permanent Pacemaker ◽  
Serological Testing ◽  
Conduction Disturbances ◽  
Lyme Carditis ◽  
Life Threatening ◽  
Life Threatening Complication

A sportive man in his 50's from Philadelphia with a brutal syncope from Lyme carditis In the case of a syncope at a young age in a patient with no medical history - especially if he or she comes from endemic regions - Lyme disease should be excluded through serological testing. Lyme carditis is a potentially life-threatening complication after infection with the bacterium Borrelia burgdorferi. This is shown in the discussed case of a 51-year-old sportive man who registered for a consultation after a brutal syncope. Under antibiotic therapy, the severe conduction disturbances progressively cleared up and a permanent pacemaker could be avoided.

Ventricular response during irregular atrial pacing and atrial fibrillation

1990 ◽  
Vol 259 (4) ◽  
pp. H1015-H1021 ◽  
Author(s):  
F. J. Chorro ◽  
C. J. Kirchhof ◽  
J. Brugada ◽  
M. A. Allessie
Keyword(s):  
Atrial Fibrillation ◽  
Inverse Relationship ◽  
Rabbit Heart ◽  
Ventricular Rate ◽  
Atrial Pacing ◽  
Av Block ◽  
Av Node ◽  
Ventricular Response ◽  
Cycle Lengths ◽  
Second Degree

In the isolated rabbit heart the ventricular response during irregular atrial pacing and atrial fibrillation was studied. Irregular pacing was performed by an algorithm that generated a population of random stimuli within a chosen range of intervals. During incremental regular pacing atrioventricular (AV) Wenckebach conduction occurred at an atrial cycle length of 164 +/- 24 ms (n = 11). During irregular atrial pacing with a variation of 20, 60, and 100 ms second-degree AV block developed at average cycle lengths of 171, 182, and 198 ms, respectively. In contrast, the pacing interval resulting in stable 2:1 AV block was shortened from 131 ms to 120 and 112 ms during irregular pacing with 20- and 60-ms variation. During pacing with 100-ms variation stable 2:1 AV block no longer occurred. Addition of acetylcholine (0.25-0.75 X 10(-6) M) increased the maximal degree of stable AV block during regular pacing. During irregular pacing, however, stable AV block disappeared. Instead, during second-degree AV block a monophasic inverse relationship (r = -1.5 +/- 1.7) between atrial and ventricular rates appeared as a result of an increased occurrence of concealed conduction in the AV junction. Also during electrically induced atrial fibrillation an inverse relationship was found between the atrial and ventricular rate. We conclude that the ventricular rate during atrial fibrillation is not only determined by the properties of the AV node but also by the rate and irregularity of the fibrillatory process.

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