HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abraham, P. Articles by Enon, B. Search for Related Content PubMed PubMed Citation Articles by Abraham, P. Articles by Enon, B. Related Collections Mediastinum Chest wall

Eur J Cardiothorac Surg 2001;20:1095-1100
© 2001 Elsevier Science NL

Infra-stellate upper thoracic sympathectomy results in a relative bradycardia during exercise, irrespective of the operated side

^a Department of Vascular Investigations and Sports Medicine, University Hospital, 49033 Angers cedex 01, France
^b Department of Cardio-Vascular and Thoracic surgery, University Hospital, 49033 Angers cedex 01, France

Received 16 May 2001; received in revised form 10 August 2001; accepted 4 September 2001.

Corresponding author. Tel.: +33-241-35-3689; fax: +33-241-35-5042
e-mail: explovasc{at}chu-angers.fr

Objective: Removal of accessory fibres coming from the sub-stellar thoracic chain to the heart during infra-stellate surgical upper thoracic sympathectomy (ISS) may be responsible for a decreased heart rate to workload relationship during exercise following surgery. We hypothesised that heart rate would decrease not only following right ISS. Methods: We performed repeated bicycle incremental exercise tests in 11 control subjects (26.9±9.5 years, 61.4±12.4 kg, 167±10 cm), and 11 patients (29.8±10 years, 59.3±12.0 kg, 168±7 cm) referred for bilateral ISS: results are mean±standard deviation. Surgery was performed at two distinct times allowing to study the consequences of unilateral and bilateral sympathectomy to confirm whether a significant relative bradycardia was constant and dependent on the operated side. Results: For control subjects, test durations were 13.55±3.29, 14.09±4.01 and 13.00±3.26 min and heart rates were 187±7, 187±8 and 186±7 beats min^-1 at the first, second and third test, respectively. Although time to exhaustion was comparable to controls and unchanged between tests: 12.32±2.87, 12.3±2.90, 12.33±3.76 min, heart rate at maximum exercise decreased significantly from 176±16 to 164±15, and 148±15 beats min^-1, before, following unilateral and bilateral ISS, respectively. The operated side did not allow for the prediction of the effect of unilateral sympathectomy. Conclusions: Patients should be informed of the exercise bradycardia resulting from ISS, although clinical tolerance seems excellent in endurance exercise. Contrary to previous reports at rest, during exercise no right-sided dominance was observed. These findings are consistent with reports of random distribution of sub-stellate cardiac fibres from anatomical studies.

Key Words: Sympathectomy • Collateral effects • Palmar hyperhidrosis • Complications • Exercise • Bicycle • Heart rate

This article has been cited by other articles:

				A. D.L. Sihoe, R. W.T. Liu, A. K.L. Lee, C.-W. Lam, and L.-C. Cheng Is Previous Thoracic Sympathectomy a Risk Factor for Exertional Heat Stroke? Ann. Thorac. Surg., September 1, 2007; 84(3): 1025 - 1027. [Abstract] [Full Text] [PDF]

				P. Abraham, J. Berthelot, J. Victor, J.-L. Saumet, J. Picquet, and B. Enon Holter changes resulting from right-sided and bilateral infrastellate upper thoracic sympathectomy Ann. Thorac. Surg., December 1, 2002; 74(6): 2076 - 2081. [Abstract] [Full Text] [PDF]