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During the acute phase of
Lyme disease, a 56-year-old man without previous heart
disease developed complete heart block with alternating left and right bundle branch block pattern QRS complexes. Electrophysiological study performed in the acute phase revealed marked HV prolongation, although the level of heart block was at the atrioventricular node. The heart block was mildly symptomatic and resolved (as did the bundle branch block) with antibiotic therapy.
Lyme disease may cause reversible His-Purkinje