Effect of procedural refinement of transfemoral transcatheter aortic valve implantation on outcomes and costs: a single-centre retrospective study.

Objectives: To determine the effect of introducing several procedural refinements of transfemoral transcatheter aortic valve implantation (TAVI) on clinical outcomes and costs.

Design: Retrospective analysis comparing two consecutive 1-year periods, before and after the introduction of procedural refinements.

Setting: Tertiary hospital aortic valve programme.

A rare cause of reversible complete heart block.

Lyme disease is a recognised cause of atrioventricular heart block. In the majority of cases conduction disturbances are reversed with antibiotic treatment. The diagnosis of Lyme disease is not always obvious and its recognition is important if unnecessary implantation of a permanent pacemaker is to be avoided.