Advanced Heart Block in Children with Lyme Disease

Meena Bolourchi, Eric S. Silver, Leonardo Liberman


Original Article




The clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.


To review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.


An IRB approved single-center retrospective study was conducted of all patients < 21 years old with confirmed Lyme disease and advanced second or third degree heart block between 2007 and 2017.


Twelve patients (100% male) with a mean age of 15.9 years (range 13.2–18.1) were identified. Six patients (50%) had mild to moderate atrioventricular valve regurgitation and all had normal biventricular function. Five patients had advanced second degree heart block and 7 had complete heart block with an escape rate of 20–57 bpm. Isoproterenol was used in 4 patients for 3–4 days and one patient required transvenous pacing for 2 days. Patients were treated with 21 days (n = 6, 50%) or 28 days (n = 6, 50%) of antibiotics. Three patients received steroids for 3–4 days. Advanced heart block resolved in all patients within 2–5 days, and all had a normal PR interval within 3 days to 16 months from hospital discharge.


Symptomatic children who present with new high-grade heart block from an endemic area should be tested for Lyme disease. Antibiotic therapy provides quick and complete resolution of advanced heart block within 5 days, while steroids did not appear to shorten the time course in this case series. Importantly, no patients required a permanent pacemaker.



Two things stick out 1) These are all kids 2) They need to be followed for a much longer period of time.  There is a third thing as well and that’s the ineffectiveness of steroids, which has long been known, as catabolic steroids will suppress the immune system allowing the infection to worsen.  Many a Lyme/MSIDS patient has had to learn that fact the hard way.  The next question begging to be asked is are these kids were infected with other TBI’s (tick borne infections) such as Bartonella, Babesia, Mycoplasma, and numerous viruses?  After all, one tick bite could give you 18 and counting different infections:  This link shows the importance of overlapping treatment with many antimicrobials to effectively treat a pleomorphic (shape-shifting), complex bacteria(ish) organism that pretty much defies all convention in the infectious world.  It’s complexity has never been taken seriously by main-stream medicine.

Myopic and limited research such as this worries me greatly.  These kids are young and have full lives ahead of them.  Due to the lack of recognition and acceptance of the complexity of the organisms involved, these children in my mind are in harm’s way and are in great risk of developing serious issues in the not so distant future.  

Please spread the word!

For more on Lyme:

Key Quote: “Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

And I’ll bet that 65% is still low….