еКорпус – библиографски запис
Can heart rate variability be utilized to predict compensatory sweating after endoscopic thoracic sympathicotomy in patients with primary focal hyperhidrosis?
Да ли се варијабилност срчане фреквенције може користити за предвиђање компензаторног знојења након ендоскопске торакалне симпатикотомије код болесника са примарном фокалном хиперхидрозом?
- Часопис
- Serbian Archives of Medicine
- Објављено
- Srp Arh Celok Lek. 2026;154(9–10):484–489.
- Врста рада
- ORIGINAL ARTICLES
Abstract
Introduction/Objective Hyperhidrosis is a condition of pathologically excessive sweating that exceeds the body’s physiological requirements for thermoregulation. Endoscopic thoracic sympathicotomy (ETS) is a commonly used treatment for primary focal hyperhidrosis (PFH); however, it may result in compensatory sweating (CS), which represents its most frequent postoperative complication. This study aimed to investigate whether heart rate variability (HRV) parameters could predict CS.
Methods A prospective single-center study was conducted in 100 patients with PFH who underwent ETS. Preoperatively, all patients underwent 24-hour Holter electrocardiographic monitoring to assess standard HRV parameters. ETS was performed by transection of the sympathetic chain at the level of the third (R3) and fourth (R4) ribs, including the accessory Kuntz fibers. One month after surgery, the presence and severity of CS were assessed.
Results CS was absent in 61% of patients (p = 0.028). Mild CS was the most common form (p < 0.01). No statistically significant differences were observed in the analyzed preoperative HRV parameters between patients with and without CS (p > 0.05), including the low-frequency (LF)/high-frequency (HF) ratios, which represent balanced autonomic activity (LF/HF < 2) and sympathetic predominance (LF/HF ≥ 2). Receiver operating characteristic curve analysis showed that age had significant predictive accuracy for CS (area under the curve 0.7333; 95% confidence interval 0.634–0.833; p < 0.01), with an optimal cut-off of 23.5 years (sensitivity 0.82, specificity 0.47).
Conclusion HRV parameters cannot reliably predict CS following bilateral ETS in patients with PFH. The study confirmed that the optimal age for surgery is below 23.5 years.
Keywords: video-assisted thoracic surgery; sweating; sympathectomy; autonomic nervous system; minimally invasive surgery