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Borrelia burgdorferi (B. burgdorferi) is a spirochete bacterium that is transmitted via the Ixodes tick. Infection results in Lyme disease with possible cardiac manifestations, which is also known as Lyme carditis. Patients can present with bradycardia due to rapidly fluctuating atrioventricular block (AVB), which is the hallmark of Lyme carditis. However, we present a rare case of sick sinus syndrome (SSS) without AVB in a 47-year-old man with Lyme disease. He initially presented with adoi:10.1016/j.idcr.2020.e00761 pmid:32368492 pmcid:PMC7190756 fatcat:kcjh6262enfj5ndg2jmn3vdneu