Abstract
Interruption of cardiac sympathetic nerves in the management of ectopic supraventricular tachycardias may be achieved by injecting anesthetics or alcohol or by surgical resection. For maximum effectiveness the procedure should include at least the first through the fifth thoracic sympathetic ganglia bilaterally. These techniques are considered most useful in cases of frequently recurring or severe tachycardias that cannot be controlled by conventional measures and in some cases of tachycardia secondary to mitral stenosis. A survey of the literature shows that fair to excellent results have been reported in 23 of 29 cases employing these procedures, and that bilateral surgical resection has been the most successful. In the case here described, a 36-year-old man suffered from a severe, recurrent paroxysmal atrial flutter-fibrillation unresponsive to drugs. Bilateral thoracic sympathectomy afforded good relief for 8 1/2 months.
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