Effect of endoscopic transthoracic sympathicotomy on heart rate variability in severe angina pectoris

The American Journal of Cardiology
H TygesenC Wettervik

Abstract

Endoscopic transthoracic sympathicotomy (ETS) is a recently developed technique to divide sympathetic nerves. ETS has been shown to improve symptoms and reduce ischemia in patients with severe angina pectoris. Low heart rate variability (HRV) in patients with ischemic heart disease carries an adverse prognosis. HRV reflects autonomic response of the heart and a shift in the sympathovagal balance towards parasympathetic dominance could be a marker of improved prognosis. HRV might also be used as an indicator of surgical success in sympathetic heart denervation. Heart rate was recorded in 57 patients before and after ETS. Registration was recorded during controlled respiration in the supine position and at tilt test over 10 minutes and spectral analysis was performed. Twenty-four hour Holter recordings were analyzed in the time domain. During the controlled setting, the high-frequency (HF) component (0.15 to 0.40 Hz) increased significantly whereas the low-frequency (LF) component (0.04 to 0.15 Hz) did not change significantly. The LF/HF ratio at tilt test was reduced from 1.3 to 0.8 (p <0.01). The time-domain analysis showed a significant increase of the mean RR interval (923 to 1,006 ms, p <0.001) and indexes reflecting parasym...Continue Reading

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Citations

Mar 20, 2003·The Annals of Thoracic Surgery·Pierre AbrahamBernard Enon
Jul 6, 2014·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Milos DobiasPaul Johnston
Mar 9, 2000·Hospital Medicine·N ChaudhuriA J Ritchie

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