Medical Health Encyclopedia

Heart Arrhythmia. Lyme disease, in some cases, effects the electrical conduction to the heart and can disrupt heart rhythms. Mild heart involvement usually responds to oral antibiotics. Severe disturbances in heart rhythms require intravenous antibiotics. Heart monitoring is important. For some patients, it may be necessary to insert a pacemaker for a week or two, although a permanent pacemaker is rarely needed.

Treating Post-Lyme Disease Syndrome

In about 10% of cases after treatment symptoms persist, a condition referred to as post-Lyme disease syndrome. In such cases, patients have persistent fatigue, muscle and joint aches, and neurologic symptoms. Treatment for this syndrome is highly controversial.

Intravenous Antibiotics. Some doctors believe that patients with such chronic symptoms have been inadequately treated previously. They recommend extremely aggressive treatments with 30 days of intravenous antibiotics followed by a month of oral doxycycline. This approach has some significant risks.

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An important 2001 study compared a group of patients with this antibiotic regimen with a group that received a placebo. All of these patients had been previously treated for Lyme and reported persistent pain, fatigue, and neurologic symptoms. After treatment, there were no differences among any of the treatment approaches, including the placebo. In general, 36% of patients improved, 39% worsened, and 25% experienced no change. None of the patients showed any evidence of persistent infection with B. burgdorferi. Two 2004 studies confirmed that additional antibiotics have no beneficial effects on patients with Lyme disease symptoms who had previously received antibiotic therapy.

Such findings do not mean that post-Lyme disease syndrome is simply a psychologic problem, but rather that this condition is probably not treatable with antibiotics. Such patients still require a careful and well-thought out treatment plans.