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The Heart Rate and ECG Changes after Endoscopic Thoracic Sympathectomy in Patients with Primary Hyperhidrosis  

Kim, Jae-Jun (Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kim, Young-Du (Department of Thoracic and Cardiovascular Surgery, Holy Family Hospital, The Catholic University of Korea College of Medicine)
Park, Chan-Beom (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, The Catholic University of Korea College of Medicine)
Moon, Seok-Whan (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, The Catholic University of Korea College of Medicine)
Cho, Deog-Gon (Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
Sa, Young-Jo (Department of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Seo, Jong-Hee (Department of Thoracic and Cardiovascular Surgery, Ujeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kim, Chi-Kyeong (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, The Catholic University of Korea College of Medicine)
Publication Information
Journal of Chest Surgery / v.42, no.2, 2009 , pp. 214-219 More about this Journal
Abstract
Background: Primary focal hyperhidrosis is characterized by overactivity of the sympathetic nervous function, and this has been effectively treated with endoscopic thoracic sympathetic denervation (ESD). The imbalance of sympathetic and parasympathetic nervous system that's created by ESD may affect the heart, lung and other thoracic organs. We analyzed the heart rate and ECG changes after performing ESD at our hospital, and this is the first such study that has been conducted on this. Material and Method: Of the 263 patients who underwent ESD between October 1996 and October 2006, 130 had ECG before and after ESD, and they were classified into 3 groups according to the level of ESD: Group I (n=40) patients underwent ESD at the 2nd rib (T2ESD), Group II (n=80) at the 3rd rib (T3ESD) and Group III (n=10) at the 4th rib (T4ESD). Result: There was no mortality or major morbidity. Heart rate (HR) was significantly decreased from $71.6{\pm}10.6/min\;to\;66.8{\pm}10.2/min$ after ESD (p<0.01); however, the PR (from $148.6{\pm}21.2$ msec to $152.8{\pm}20.5$ msec) and QTc (from $399.2{\pm}15.4$ msec to $404.0{\pm}15.1$ msec) intervals were significantly increased after ESD in the patients who suffered with primary hyperhidrosis (p<0.01). According to the level of ESD, there were significant changes in the HR and QTc interval in group I (T2ESD), the HR and PR interval in group II and the QTc interval in Group III. Conclusion: There were significant changes in the heart rate and ECG findings after ESD. The thoracic sympathetic denervation of T2, T3 and T4 affected the electrical activity of the heart at the resting state.
Keywords
Hyperhidrosis; Sympathicotomy; Electrocardiography;
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1 Gossot D, Kabiri H, Caliandro R, Debrosse D, Girard P, Gruenwald D. Early complications of thoracic endoscopic sympathectomy; a prospective study of 940 procedures. Ann Thorac Surg 2001;71:1116-9   DOI   ScienceOn
2 Drott C, Claes G, Gothberg G, Paszkowski P. Cardiac effects of endoscopic electrocautery of the upper thoracic sympathetic chain. Eur J Surg 1994;160(Suppl 572):65-70
3 Schiller Y. The anatomy and physiology of the sympathetic innervation to the upper limbs. Clin Auton Res 2003; 13(suppl1):I2-5
4 Senard JM, Simonetta-Moreau M, Tran MA. Blood pressure and heart rate variability in patients with essential hyperhidrosis. Clin Auton Res 2003;13:281-5   DOI   ScienceOn
5 Tedoriya T, Sakagami S, Ueyama T, Thompson L, Hetzer R. Influences of bilateral endoscopic transthoracic sympathicotomy on cardiac autonomic nervous activity. Euro J Cardiothorac Surg 1999:15:194-8   DOI   ScienceOn
6 Jo KH, Moon SW, Kim YD, et al. New protocol for a reversal operation in endoscopic thoracic sympathetic clamping: pulling back the suture sling linked to the clip under local anesthesia. Surg Laparosc Endosc Percutan Tech 2007;17:29-32   DOI   ScienceOn
7 Szentivany A. The beta-adnergic theory of the atopic abnormality I bronchial asthma. J Allergy Clin Immunol 1968;42: 203-20
8 Nakamura Y, Fujimoto M, Nagatta Y, et al. Effects of endoscopic transthoracic sympathicotomy on hemodynamic and neurohumoral respanses to excercise in humans. Circ J 2002;66:357-61   DOI   ScienceOn
9 Moon SW, Kim YW, Cho KH, Wang YP, Kwack MS, Kim SW. Evaluation of cardiopulmonary function after thoracic sympathectomy. 30th Annual Meeting of Korean Society of Thoracic and Cardiovascular Surgery 1998; Abstract 37
10 Janes RD, Brandys JC, Hopkins DA, Johnstone DE, Murphy DA, Armour JA. Anatomy of human extrinsic cardiac nerves and ganglia. Am J Cardiol 1986;57:299-309   DOI   ScienceOn
11 Wang LX. Role of left cardiac sympathetic denervation in the management of congenital long QT syndrome. J Postgrad Med 2003;49:179-81
12 Vigil L, Calaf N, Codina E, Fibla JJ, Gomez G, Casan P. Video-assisted sympathectomy for essential hyperhidrosis: effects on cardiopulmonary function. Chest 2005;128:2702-5   DOI   ScienceOn
13 Wilkinson HA, Bryant GDN, Orgain ES. The supraventricular tachycardias: management by interruption of cardiac sympathetics. JAMA 1961;175:672-7   DOI
14 Barnes PJ. Neural control of human airways in health and disease. Am Rev Respir Dis 1986;134:1289-314   PUBMED
15 Schwartz PJ, Locati EH, Moss AJ, Crampton RS, Trazzi R, Ruberti U. Left cardiac sympathetic denervation in the therapy of congenital long QT syndrome. A worldwiede report. Circulation 1991;84:503-11   DOI   PUBMED
16 Kadowaki MH, Levett JM. Sympathectomy in the treatment of angina and arrhythmias. Ann Thorac Surg 1986;41:572-8   DOI   PUBMED
17 Claes G, Drott C, Gothberg G. Thoracoscopy for autonomic disorders. Ann Thorac Surg 1993;56:715-6   DOI   PUBMED
18 Drott C. Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm. Clin Auton Res 2003;13(suppl 1):I26-30
19 Noppen M, Dendale P, Hagers Y, Herregodts P, Vinken W, D’Haens J. Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis. J Autonom Nerv Sys 1996;60:115-20   DOI   ScienceOn
20 Ting H, Lee SD, Chung AH, et al. Effects of bilateral T2-sympathectomy on static and dynamic heart rate response to excercise in hyperhidrosis. Auton Neurosci 2005;121: 74-80   DOI   ScienceOn
21 Papa MZ, Bass A, Schneiderman J, Drori Y, Tucker E, Adar R. Cardiovascular changes after bilateral upper dorsal sympathectomy. Short-and long-term effects. Ann Surg 1986;204: 715-8
22 Lai CL, Chen WJ, Liu YB, Lee YT. Bradycardia and permanent pacing after bilateral thoracoscopic T2-sympathectomy for primary hyperhidrosis. Pacing Clin Electrophysiol 2001;24:524-5   DOI   ScienceOn
23 Lin CC, Mo LR, Hwang MH. Intraoperative cardiac arrest: a rare complicaition of T2,3-sympathicotomy for treatment of hyperhidrosis palmaris. Two cases reports. Eur J Surg 1994; 160(suppl 572);43-5