Electrocardiogram as a Lyme Disease Screening Test - 23/10/21
, Mark E. Alexander, MD 2, Jonathan E. Bennett, MD 3, Fran Balamuth, MD, PhD 4, Aris Garro, MD, MPH 5, Michael N. Levas, MD 6, Amy D. Thompson, MD 3, Anupam B. Kharbanda, MD, MSc 7, David P. Lewander, BS 8, Arianna H. Dart, BA 8, Lise E. Nigrovic, MD, MPH 8for Pedi Lyme Net
Abstract |
Objective |
To examine the association between electrocardiographic (ECG) evidence of carditis at the time of Lyme disease evaluation and a diagnosis of Lyme disease.
Study design |
We performed an 8-center prospective cohort study of children undergoing emergency department evaluation for Lyme disease limited to those who had an ECG obtained by their treating clinicians. The study cardiologist reviewed all ECGs flagged as abnormal by the study sites to assess for ECG evidence of carditis. We defined Lyme disease as the presence of an erythema migrans lesion or a positive 2-tier Lyme disease serology. We used logistic regression to measure the association between Lyme disease and atrioventricular (AV) block or any ECG evidence of carditis.
Results |
Of the 546 children who had an ECG obtained, 214 (39%) had Lyme disease. Overall, 42 children had ECG evidence of carditis, of whom 24 had AV block (20 first-degree). Of the patients with ECG evidence of carditis, only 21 (50%) had any cardiac symptoms. The presence of AV block (OR 4.7, 95% CI 1.8-12.1) and any ECG evidence of carditis (OR 2.3, 95% CI 1.2-4.3) were both associated with diagnosis of Lyme disease.
Conclusions |
ECG evidence of carditis, especially AV block, was associated with a diagnosis of Lyme disease. ECG evidence of carditis can be used as a diagnostic biomarker for Lyme disease to guide initial management while awaiting Lyme disease test results.
Le texte complet de cet article est disponible en PDF.Abbreviations : AV, COVID-19, ECG, ED
Plan
| Supported by the Boston Children's Hospital (L.N.) and the Global Lyme Alliance (L.N.). The authors declare no conflicts of interest. |
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| Portions of this study were presented at the Pediatric Academic Societies annual meeting, April 24-May 1, 2019, Baltimore, Maryland. |
Vol 238
P. 228 - novembre 2021 Retour au numéro
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