Bradycardia and permanent pacing after bilateral thoracoscopic T2-sympathectomy for primary hyperhidrosis

A 23-year-old woman with craniofacial hyperhidrosis underwent bilateral tho racoscopic T2-sympathectomy, Marked sinus bradycardia with a mean heart rat e 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 invasi ve electrophysiological study and unopposed vagotonia after sympathectomy F t as diagnosed. A permanent pacemaker was implanted. Although reduced heart rate is a common phenomenon after bilateral dorsal sympathectomy, intracta ble bradycardia with permanent pacing is rare. This patient demonstrates on e of the potential cardiac complications of bilateral sympathectomy,