Borrelia burgdorferi as a cause of Morgagni-Adams-Stokes syndrome

According the literature atrio-ventricular blockade (AVB) is the most frequ ent and well-known symptom of Lyme carditis. Typical signs of complete AVE include fatigue, lethargy and syncope- Margagni-Adams-Stokes syndrome (MAS) . The authors present their results and experience with 5 patients selected f rom a long-term study (conducted between 1987 and 1998) comprising 58 patie nts who developed MAS. The authors tried to evaluate the changes especially in the cardiovasvcular system. They correlated the clinical stale with ECG findings, as well as w ith 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 develope d ventricular fibrillation), 3) two patients had frequent symptomatic and a symptomatic arrhythmia including chest pain and episodic rest dyspnea, 4) s ubjective difficulties (usually palpitations) correlated with ECG findings (Lown 3a, 3b). The authors also looked for any relationship between clinica l 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.