title: Endoscopic transthoracic sympathicotomy affects the autonomic modulation of heart rate in patients with palmar hyperhidrosis.
abstract: BACKGROUND
  Palmar hyperhidrosis has been associated with an increased activity of the sympathetic nervous system. The objective of this study was to assess the immediate and long-term effects of endoscopic transthoracic sympathicotomy on the autonomic modulation of the heart rate in patients with palmar hyperhidrosis.
  
  
  METHODS
  Power spectrum analysis of heart rate variability in the lying position and after passive tilt to the upright position was performed in thirteen patients the day before and after sympathicotomy. A follow-up recording was performed in ten patients approximately six months later. Recordings from 26 healthy subjects were used as a reference group.
  
  
  RESULTS
  The patients had a tendency to higher power of the low-frequency (LF: 0.04-0.15 Hz) and high-frequency (HF; above 0.15 Hz) components than controls in the upright position. After sympathicotomy LF power was reduced, but HF power was unchanged. At follow-up LF power remained at a lower level, but now HF power was reduced.
  
  
  CONCLUSIONS
  Patients with palmar hyperhidrosis have a sympathetic overactivity but also a compensatory high parasympathetic activity. Sympathicotomy results in an initial sympathovagal imbalance with a parasympathetic predominance, which is restored on a long-term basis.
authors.affiliation: Department of Biomedical Engineering & Informatics, University Hospital, Umeå, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Wiklund
authors.forename: L O
authors.initials: LO
authors.lastname: Koskinen
authors.forename: U
authors.initials: U
authors.lastname: Niklasson
authors.forename: P
authors.initials: P
authors.lastname: Bjerle
authors.forename: J
authors.initials: J
authors.lastname: Elfversson
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D004724:Endoscopy; D005260:Female; D006225:Hand; D006339:Heart Rate; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013562:Sympathectomy / Q000379:methods*; D013909:Thorax; D018667:Tilt-Table Test; D013997:Time Factors