LACK OF CARDIAC MANIFESTATIONS AMONG PATIENTS WITH PREVIOUSLY TREATEDLYME-DISEASE

Background: Cardiac involvement is common in acute Lyme disease, and c ase reports suggest that cardiac abnormalities might also occur years after the primary infection. Objective: To determine the prevalence of cardiac abnormalities in persons with previously treated Lyme disease . Design: Population-based, retrospective cohort study with controls. Setting: Nantucket Island, Massachusetts. Participants: From among 370 3 adult respondents to a total-population (n = 6046) mail survey, 336 (176 case-patients and 160 controls) were randomly selected for clinic al evaluation. Measurements: Current cardiac symptoms and major or min or abnormal electrocardiographic features, including heart rate; rhyth m; axis; PR, QRS, and QT intervals; QRS structure; atrioventricular bl ocks; and ST-segment and T-wave changes. Results: Persons with Lyme di sease (case-patients, n = 176) (mean duration from disease onset to st udy evaluation, 5.2 years) and persons without evidence of previous Ly me disease (controls, n = 160) did not differ significantly in their p atterns of current cardiac symptoms and electrocardiographic findings, including heart rate (P > 0.2), PR interval (P = 0.15), QRS interval (P > 0.2), QT interval (P > 0.2), axis (P > 0.2), presence of arrhythm ias (P > O.Z), first-degree heart block (P = 0.12), bundle-branch bloc k (P > 0.2), and ST-segment abnormalities (P > 0.2). In multivariate a nalyses that adjusted for age, sex, and previous heart disease, a hist ory of previously treated Lyme disease was not associated with either major (odds ratio, 0.78; P > O.Z) or minor (odds ratio, 1.09; P > O.Z) electrocardiographic abnormalities. Conclusion: Persons with a histor y of previously treated Lyme disease do not have a higher prevalence o f cardiac abnormalities than persons without a history of Lyme disease .