Excerpt:

A 54-year-old American woman presented with an episode of syncope. This had
occurred against a background of several days of dizziness and palpitations.
Her medical history included Bell’s palsy, which had been diagnosed three
weeks earlier. On examination, she had a resting bradycardia of 31 beats per
minute and her electrocardiogram demonstrated third-degree atrioventricular
(AV) block.
She was referred to cardiology for consideration of permanent pacemaker
implantation. Given her facial nerve palsy and AV block, a diagnosis of Lyme
borreliosis was suspected. Within 48 hours of initiation of ceftriaxone, she
reverted to sinus rhythm, albeit with a marked first-degree AV block.
Subsequent serology confirmed the diagnosis. Reversible causes of complete
AV block should always be considered and appropriate therapy may avoid the
need for permanent pacemaker insertion.

A 36year old male patient presented to emergency cardiology
department because of fatigability. ECG revealed high grade II
atrio-ventricular block and bradycardia of 31beats/min. An
erythema increasing in size to up to 7-8cm in diameter appeared a
month earlier and spontaneously resolved within 10days.
ELISA testing for antibodies against Borrelia burgdorferi IgM was
positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod,
and 0.5g metronidazole tid lead to regression of grade II block
to grade I block within 2days. Grade I block persisted for an
additional 10days. This is a relatively rare case of early
occurrence of Lyme carditis within one month of exposure as the
first sign of Lyme disease dissemination. Copyright (c) 2010.
Published by Elsevier Ireland Ltd.

A 36year old male patient presented to emergency cardiology
department because of fatigability. ECG revealed high grade II
atrio-ventricular block and bradycardia of 31beats/min. An
erythema increasing in size to up to 7-8cm in diameter appeared a
month earlier and spontaneously resolved within 10days.
ELISA testing for antibodies against Borrelia burgdorferi IgM was
positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod,
and 0.5g metronidazole tid lead to regression of grade II block
to grade I block within 2days. Grade I block persisted for an
additional 10days. This is a relatively rare case of early
occurrence of Lyme carditis within one month of exposure as the
first sign of Lyme disease dissemination. Copyright (c) 2010.
Published by Elsevier Ireland Ltd.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20226549&retmode=ref&cmd=prlinks