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The effects of thoracic sympathotomy on heart rate variability in patients with palmar hyperhidrosis.
Yonsei Med J. 2012 Nov 01; 53(6):1081-4.YM

Abstract

PURPOSE

To observe the evolution of heart rate variability (HRV) in patients with palmar hyperhidrosis before and after endoscopic thoracic sympathotomy and to evaluate the effects of the surgery on the autonomic nervous system.

MATERIALS AND METHODS

Endoscopic thoracic sympathotomy was performed on 20 patients with palmar hyperhidrosis. The thoracic sympathetic chain at the level of the third to fourth rib (R3-R4) was transected, but the ganglia were left in position without removal. A slightly larger ramus, in comparison to the other rami, that arose laterally from the sympathetic chain was interrupted to achieve adequate sympathetic denervation of the upper extremity. Before and on the day after the surgery, 24-hour Holter Electrocardiograph was performed, obtaining time domain and frequency domain parameters.

RESULTS

Compared with preoperative variables, there was a significant increase in the number of adjacent normal R wave to R wave (R-R) intervals that differed by more than 50 ms, as percent of the total number of normal RR intervals (pNN50); root mean square difference, the square root of the mean of the sum of squared differences between adjacent normal RR intervals over the entire 24-hour recording; standard deviation of the average normal RR interval for all 5-minute segments of a 24-hour recording (SDANN) after thoracic sympathotomy. Low frequencies (LF, 0.04 to 0.15 Hz) decreased significantly. There was no statistical difference in high frequencies (HF, 0.15 to 0.40 Hz), LF/HF ratio (LF/HF), or standard deviation for all normal RR intervals for the entire 24-h recording (SDNN) before and after thoracic sympathotomy.

CONCLUSION

There was a significant improvement in HRV in patients with palmar hyperhidrosis after thoracic sympathotomy. This may be attributable to an improvement autonomic nervous system balance and parasympathetic predominance in the early postoperative stage.

Authors+Show Affiliations

Department of Anesthesiology, Renmin Hospital of Wuhan University, Jie Fang Road 238#, WuHan, HuBei, China. wanglongwhu@163.com.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23074105

Citation

Zhang, Tong-yuan, et al. "The Effects of Thoracic Sympathotomy On Heart Rate Variability in Patients With Palmar Hyperhidrosis." Yonsei Medical Journal, vol. 53, no. 6, 2012, pp. 1081-4.
Zhang TY, Wang L, Xu JJ. The effects of thoracic sympathotomy on heart rate variability in patients with palmar hyperhidrosis. Yonsei Med J. 2012;53(6):1081-4.
Zhang, T. Y., Wang, L., & Xu, J. J. (2012). The effects of thoracic sympathotomy on heart rate variability in patients with palmar hyperhidrosis. Yonsei Medical Journal, 53(6), 1081-4. https://doi.org/10.3349/ymj.2012.53.6.1081
Zhang TY, Wang L, Xu JJ. The Effects of Thoracic Sympathotomy On Heart Rate Variability in Patients With Palmar Hyperhidrosis. Yonsei Med J. 2012 Nov 1;53(6):1081-4. PubMed PMID: 23074105.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of thoracic sympathotomy on heart rate variability in patients with palmar hyperhidrosis. AU - Zhang,Tong-yuan, AU - Wang,Long, AU - Xu,Jin-jin, PY - 2012/10/18/entrez PY - 2012/10/18/pubmed PY - 2013/3/15/medline SP - 1081 EP - 4 JF - Yonsei medical journal JO - Yonsei Med. J. VL - 53 IS - 6 N2 - PURPOSE: To observe the evolution of heart rate variability (HRV) in patients with palmar hyperhidrosis before and after endoscopic thoracic sympathotomy and to evaluate the effects of the surgery on the autonomic nervous system. MATERIALS AND METHODS: Endoscopic thoracic sympathotomy was performed on 20 patients with palmar hyperhidrosis. The thoracic sympathetic chain at the level of the third to fourth rib (R3-R4) was transected, but the ganglia were left in position without removal. A slightly larger ramus, in comparison to the other rami, that arose laterally from the sympathetic chain was interrupted to achieve adequate sympathetic denervation of the upper extremity. Before and on the day after the surgery, 24-hour Holter Electrocardiograph was performed, obtaining time domain and frequency domain parameters. RESULTS: Compared with preoperative variables, there was a significant increase in the number of adjacent normal R wave to R wave (R-R) intervals that differed by more than 50 ms, as percent of the total number of normal RR intervals (pNN50); root mean square difference, the square root of the mean of the sum of squared differences between adjacent normal RR intervals over the entire 24-hour recording; standard deviation of the average normal RR interval for all 5-minute segments of a 24-hour recording (SDANN) after thoracic sympathotomy. Low frequencies (LF, 0.04 to 0.15 Hz) decreased significantly. There was no statistical difference in high frequencies (HF, 0.15 to 0.40 Hz), LF/HF ratio (LF/HF), or standard deviation for all normal RR intervals for the entire 24-h recording (SDNN) before and after thoracic sympathotomy. CONCLUSION: There was a significant improvement in HRV in patients with palmar hyperhidrosis after thoracic sympathotomy. This may be attributable to an improvement autonomic nervous system balance and parasympathetic predominance in the early postoperative stage. SN - 1976-2437 UR - https://www.unboundmedicine.com/medline/citation/23074105/The_effects_of_thoracic_sympathotomy_on_heart_rate_variability_in_patients_with_palmar_hyperhidrosis_ L2 - https://www.eymj.org/DOIx.php?id=10.3349/ymj.2012.53.6.1081 DB - PRIME DP - Unbound Medicine ER -