Association between the acquisition of antibodies against Lyme disease and the risk of atrial arrhythmias

INTRODUCTION The impact of antibodies against Borrelia burgdorferi (BB) on the occurrence of cardiac arrhythmias in patients without typical symptoms of Lyme disease (LD) is largely unknown. OBJECTIVES We aimed to assess the risk of atrial fibrillation (AF) and other atrial arrhythmias (AAs) in patients who tested positive for anti-LD antibodies. PATIENTS AND METHODS We included consecutive patients referred for the diagnosis and treatment of AAs who had no history of erythema migrans or other symptoms of LD. The presence of anti-BB antibodies (immunoglobulin [Ig] M and IgG) was assessed in each patient, and the diagnostic workup of cardiac arrhythmias was performed. RESULTS Of the 527 patients enrolled in the study, 292 (55%) were diagnosed with AAs, and we detected BB antibodies in 131 individuals (24.8%). The patients with a serological history of Borrelia infection were older (mean [SD], 55.6 [15.7] vs 50.3 [18.6] years; P = 0.01), had a higher probability of developing AF or other supraventricular arrhythmias (SAs) (66.4% vs 51.8%; P = 0.03), and had elevated levels of N -terminal pro???B -type natriuretic peptide (NT -proBNP) (58% vs 47.5%; P = 0.04). We also found an association between the occurrence of AF and other SAs in patients with anti-BB antibodies and elevated NT -proBNP values, and the risk of AAs in these patients increased almost 3 -fold (P = 0.01). CONCLUSIONS Our data indicated an association between the exposure to Borrelia infection and the risk for AF and other AAs in the patients with elevated levels of NT -proBNP, suggesting the need for a more efficacious diagnostic approach to patients with SAs, especially in LD -endemic regions.