Can Lyme Disease Cause AFib or Irregular Heartbeat?
Lyme disease may increase the risk of atrial fibrillation
Lyme carditis can affect the heart’s electrical conduction system
Irregular heartbeat and palpitations may reflect cardiac inflammation
Researchers continue to investigate whether Lyme disease and Lyme carditis may contribute to atrial fibrillation (AFib), irregular heartbeat, myocarditis, and other cardiac complications.1
AFib is the most common sustained cardiac arrhythmia and may increase the risk of stroke, heart failure, and other cardiovascular complications.
For more on cardiac complications, visit our Lyme Carditis hub.
Study Examines Lyme Disease and AFib
Szymanska and colleagues examined 113 adult patients with atrial fibrillation attending a cardiac clinic in Poland between 2018 and 2019 and compared them with 109 patients without AFib.1
The mean age of participants was 75.8 years, with approximately 40% male.
Patients with AFib were more likely to have obesity, hypertension, chronic kidney disease, heart failure, and left atrial enlargement.1
The authors hypothesized that “in some cases the AF might be a consequence of past low-grade myocarditis.”1
They identified Borrelia infection and Lyme carditis as possible understudied contributors to cardiac inflammation.
Borrelia and the Heart
Multiple studies have shown that Borrelia burgdorferi may infect several parts of the heart including:
- the cardiac conduction system
- cardiac muscle
- heart valves
- blood vessels
- the interventricular septum
The authors explained that spirochete-associated inflammation often involves fibers near the base of the heart and perivascular regions.1
Unfortunately, few atrial biopsies are performed in living patients, limiting understanding of atrial inflammation related to Lyme disease.
For more on heart rhythm symptoms, visit our Lyme Disease Heart Palpitations article.
Study Findings
Szymanska reported that patients with AFib were more than 8 times more likely to have positive Borrelia antibodies.1
According to the study, 34.5% of AFib patients had positive Borrelia antibodies compared to 6.4% of patients in normal sinus rhythm.1
The presence of anti-Borrelia IgG antibodies was identified as a strong independent predictor of atrial fibrillation.1
However, the authors emphasized that association alone does not establish causation.
Possible Mechanisms Linking Lyme Disease and AFib
The authors proposed several possible explanations for the higher prevalence of AFib in Lyme disease patients.
One possibility is that low-grade inflammation from Lyme carditis may contribute to atrial remodeling and electrical instability within the heart.1
A second theory involves persistent immune activation and cross-reactive antibodies triggered by Borrelia burgdorferi infection.1
The authors suggested that bacterial persistence within extracellular tissues could potentially contribute to autoimmune injury affecting cardiac tissue.
Limitations of the Study
The authors acknowledged several important limitations.
The study did not include confirmatory Western blot testing due to cost and availability limitations.1
The findings therefore require confirmation through larger and better-designed studies.
Importantly, the study demonstrates association—not proof that Lyme disease directly causes atrial fibrillation.
Why Lyme Carditis May Be Missed
Patients with Lyme carditis may present with palpitations, dizziness, syncope, chest discomfort, shortness of breath, or fluctuating conduction abnormalities.
Some patients may initially be diagnosed with primary cardiac disease without recognition of possible tick-borne infection.
Delayed diagnosis may increase the risk of more serious cardiac complications.
For more on delayed recognition, visit our Delayed Lyme Disease Diagnosis hub.
Frequently Asked Questions
Can Lyme disease cause AFib?
Some studies suggest Lyme disease and Lyme carditis may be associated with an increased risk of atrial fibrillation, although causation has not been definitively proven.1
Can Lyme disease cause heart palpitations?
Yes. Lyme carditis may cause palpitations, irregular heartbeat, conduction abnormalities, or dizziness.
What is Lyme carditis?
Lyme carditis is a cardiac complication of Lyme disease involving inflammation affecting the heart’s electrical conduction system or cardiac tissue.
Can infection trigger AFib?
Yes. Infections and inflammatory conditions may contribute to atrial fibrillation in some patients.
Can Lyme disease affect the heart?
Lyme disease may affect the conduction system, heart muscle, valves, or surrounding cardiac tissues.
Can Lyme carditis improve with treatment?
Many patients improve with appropriate antibiotic treatment, though severe cardiac involvement may require hospitalization or pacing support.
Clinical Takeaway
Lyme disease and Lyme carditis may contribute to atrial fibrillation, palpitations, myocarditis, and conduction abnormalities in some patients.
Patients presenting with new cardiac symptoms in endemic areas may warrant evaluation for possible tick-borne infection.
AFib and irregular heartbeat may represent underrecognized manifestations of Lyme carditis and cardiac inflammation.
Related Articles
These related articles explore Lyme carditis, cardiac rhythm abnormalities, autonomic dysfunction, neurologic complications, and delayed recognition.
Lyme Carditis Presenting as Atrial Fibrillation
Podcast: Severe Cardiac Lyme Disease
Lyme Disease Misdiagnosis
Autonomic Dysfunction in Lyme Disease
Neurologic Lyme Disease
References
- Szymanska A, Platek AE, Dluzniewski M, Szymanski FM. History of Lyme Disease as a Predictor of Atrial Fibrillation. Am J Cardiol. 2020;125(11):1651-1654.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I was diagnosed with A Fib in 2017 after a bad reaction to Targretin and Levothyroxine, taken for NHL.
Only God knows if the Bb and Babesia, acquired in 1995, contributed to the pathology.
Are there Lyme cardiologists in the US…or at least cardiologists who understand Lyme Disease and the devastation it causes in the body?
I use cardiologist primarily to be sure I have not overlooked another illness.
I use cardiologist primarily to be sure I have not overlooked another illness.
Are there Lyme cardiologists in the US…or at least cardiologists who understand Lyme Disease and the devastation it causes in the body?
We are in Michigan and I just had the family practice tell me my husbands joint quick onset and AFIB and my joints also Lyme (my test is positive) infected have nothing to do with Lyme. My gosh we need Kennedy to step in for this.
There are so many causes of a fib. In some cases the cause has never been identified. I have included Lyme disease in my evaluation particularly if there are other issues including joint pain.
In 2008 I was taking a shower and notice the right calf of my leg was swollen and had a big bullseye redness on it. I did not see a tick but we live in the on a mountain in PA and often get tick bites. I went to the doctor who said she thought it was a tick bite and gave me 3 antibiotics pills to take. Since then I have large knees that are painful and hot and I am very tried a lot. My hands are sore mostly my thumbs. I see floating color spots and my eye site blurry. I did get checked about 5 years after the bite again for limes and it came back all but one marker was positive for limes so I was told o do not have limes disease. I now have AFib. And I often wonder did they miss diagnose me?
I have not found the laboratory tests all that reliable. I have had to treat some of my patients based on clinical judgement rather than relying solely on the test. I have always encouraged someone who has bee ill for years after a tick and rash to be reevaluated by a doctor experienced in treating Lyme disease. BTW I would not be comfortable with “3” doxycycline after a tick bite.
During the summer of 1998 I was walking home in a pair of shorts due to hot weather, when I returned home I noticed a slight itching on the shin of my leg, I went to bed and when I awoke the next morning my leg had swelled up considerably and there was a red bullseye mark. I went to see my GP and he told me to go straight to the emergency dept. I was kept in hospital for 3 nights to treat the bite and returned home. Approx 3 years later I began having palpations which eventually was diagnosed as atrial fibrillation (lone afib). Could there be a link to the bite and the afib?
There are so many causes of atrial fibrillation. I reported on a published case in my blog to encourage doctors to look a second time for Lyme disease.
I had Lyme disease in 2008 treated with 3 months of iv rocephin. I have had afib not crontrolled well for several years. This winter had heart failure due to the afib. They tried to do electro cardoiversion which worked for a few days but returned to afib. I am on metoprolol, jardiance, lasix, xarelto and losartan. The electrocardiologiat said abblation will likely not work and rec to do a pacemaker. Want to be sure this is the right approach .
There are so many causes of atrial fibrillation to consider. I still look for evidence of a tick borne illness.
I had a cardiac ablation at John’s Hopkins less than two years ago for SVT (Holter Monitor captured 230 bpm for 23 mins). I’d been previously diagnosed twice (2 different strains) with Lyme disease. I asked then if the Lyme had produced this, since I’d not had heart issues before infection. It was unknown. Since the procedure, I have not had an episode of tachycardia. I’ve learned that about 30% of the population seems to have chronic Lyme symptoms, and I was being treated with pulse doses of antibiotics for continuing symptoms. I guess I’m wondering if I’d be a candidate for an atrial biopsy at any point. Thank you for your dedication to this.
I prescribe daily treatment in my practice.
I have had palpitations on and off for some years. A few months ago I experienced them again and the next day noticed a tick on my leg. The palpitations lasted about a week. Could a tick bite cause palpitations in isolation or should I be checked for Lymes disease?
Palpitation can occur in isolation. Palpitations can indicate POTS, a condition seen in Lyme disease. I also have had patients with both a history of Lyme and palpitations.
I developed afib in 2019, not long after I had found an embedded tick. I was not evaluated or treated for Lyme disease at the time. After a difficult year with increasingly severe afib symptoms that resisted other treatments, I had a cardiac ablation in July 2020 and the afib stopped. Three weeks ago, I found another tick on my leg, in February 2024. I have been diagnosed with Lyme disease this time . My afib has returned, unfortunately, despite two weeks of antibiotic treatment with doxycycline.
I included my understanding of the cardiac cases to encourage my colleagues to discuss the topic. I hope you resolve your issues.
Why are doctors so illiterate in treating diseases that have been around since the
70’s in the USA Really no excuse for this uneducated population. Lay people understand it better living with it. May god save us all.