LAUSR

A 28‐year‐old previously healthy male presented with nonprodromal syncope and a 4‐day history of chest pain, shortness of breath, and malaise. His ECG showed rapidly progressive high‐degree AV block. His Suspicious Index in Lyme Carditis (SILC) score was 8, indicating high risk for Lyme carditis. Lyme serology revealed to be positive (anti‐Lyme IgM). During the second day of hospitalization, the patient deteriorated his AV conduction, and a temporary–permanent pacemaker was implanted allowing ambulating in hospital the very same day. Temporary–permanent pacemakers for the management of transient high‐degree heart block associated with Lyme carditis were only occasionally used in the past.