cardiac viral infection

Posted By  CCF Cardio MD - DLB on February 11, 1998 at 10:44:51:

In Reply to: cardiac viral infection posted by Peter on January 24, 1998 at 19:46:34:

: Hello I have posted a recent question regarding the association between an
  atrial arrhythmia and the action of swallowing.  I have always suspected
  that I have become exposed to some infection or that perhaps I have become
  sensitised to some foriegn agent.  How likely is it that some virus/bacteria
  could be causing atrial arrhythmias?  The arrhythmia is generally PSVT with
  isolated afib that lasts up to 6 hours.  EP study and echo all are negative.
  I have also noticed that my liver shows up fatty on ultrasound. I am always leading wilderness canoe trips into tick country and so the idea
  of Lyme's disease has crossed my mind.  I would like to know what tests can
  be done to rule out these possibilities.  One doctor told me that unless I
  test for a specific virus it will not show up on routine blood tests.
  Any advice would be appreciated.  Thankyou - Peter

[CCF CARDIO MD DLB]

_
Dear Peter,
You have posed some very interesting questions.  I have encountered a handful of patients who state that their atrial arrhythmias are associated with swallowing, usually of ice-cold substances.  This is possibly due to the fact that the esophagus (the "food pipe") is located right next to the left atrium and is somehow irritated, causing atrial arrhythmias in people with such a predisposition.  
Lyme disease is a well-known cause (though a rare one) of heart block.  Heart block is the situation in which the top and bottom chambers of the heart do not communicate with one another.  Lyme disease has also been associated with atrial arrhythmias, but even more infrequently.  There are different blood tests for Lyme diesease, but they vary widely in terms of clinical utility.  
Fever and infection of any sort can precipitate atrial arrhythmias in people with a predisposition.  However, there are usually other signs of infection that are manifest, not solely atrial arrhythmia.  Basic laboratory testing, in addition to a medical history and physical, usually reveal any underlying infection in theses situations.
I hope this information has been useful to you.  If you wish to be evaluated here at the Cleveland Clinic, please call 1-800 CCF CARE for an appointment with an electrophysiologist at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.