title: Bradycardia and permanent pacing after bilateral thoracoscopic T2-sympathectomy for primary hyperhidrosis.
abstract: A 23-year-old woman with craniofacial hyperhidrosis underwent bilateral thoracoscopic T2-sympathectomy. Marked sinus bradycardia with a mean heart rate of 49 beats/min by Holter ECG monitoring occurred after the procedure and persisted for > 2 years. Normal sinus node function was found by an invasive electrophysiological study and unopposed vagotonia after sympathectomy was diagnosed. A permanent pacemaker was implanted. Although reduced heart rate is a common phenomenon after bilateral dorsal sympathectomy, intractable bradycardia with permanent pacing is rare. This patient demonstrates one of the potential cardiac complications of bilateral sympathectomy.
authors.affiliation: Department of Emergency Medicine, National Taiwan University, 7 Chung-Shan South Rd., Taipei 10016 Taiwan.
authors.forename: C L
authors.initials: CL
authors.lastname: Lai
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
authors.forename: Y B
authors.initials: YB
authors.lastname: Liu
authors.forename: Y T
authors.initials: YT
authors.lastname: Lee
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000628:therapy*; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000294:innervation; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000628:therapy*; D013562:Sympathectomy; D013906:Thoracoscopy