The Journal of Pediatrics published a study examining the use of electrocardiographic (ECG) evidence of carditis as a diagnosis of Lyme disease.
GLA is proud to have funded this important study on electrocardiographic (ECG) evidence of carditis at the time of Lyme disease evaluation when diagnosing Lyme in children. According to Mayla Hsu, Ph.D., Director of Science and Research at GLA, "these results will improve the diagnosis and care of Lyme disease in children, because carditis can be diagnosed by ECGs performed in the emergency room. In contrast, blood test results may take days, leading to treatment delays. Hopefully these findings will be incorporated into the standard of care for children suffering from suspected Lyme disease."
Study design
Doctors performed an eight-center prospective cohort study of children undergoing emergency department evaluation for Lyme disease limited to those who had an ECG obtained by their treating clinicians. The study cardiologist reviewed all ECGs flagged as abnormal by the study sites to assess for ECG evidence of carditis. We defined Lyme disease with the presence of an erythema migrans lesion or a positive two-tier Lyme disease serology. We used logistic regression to measure the association between Lyme disease and AV block or any ECG evidence of carditis.
Results
Of the 546 children who had an ECG obtained, 214 (39%) had Lyme disease. Overall, 42 children had ECG evidence of carditis of which 24 had atrioventricular (AV) block (20 first degree). Of the patients with ECG evidence of carditis, only 21 (50%) had any cardiac symptoms. The presence of AV block (odds ratio 4.7, 95% confidence interval 1.8-12.1) and any ECG evidence of carditis (odds ratio 2.3, 95% confidence interval 1.2-4.3) were both associated with diagnosis of Lyme disease.
Abbreviations:
atrioventricular ((AV)), electrocardiogram ((ECG)), confidence interval ((CI))
