Surgical therapy for Wolff-Parkinson-White syndrome in patients with bronchial asthma

The surgical therapy for Wolff-Parkinson-White syndrome in patients with bronchial asthma was studied. Between 1974 and 1992, 447 patients with Wolff-Parkinson-White syndrome were treated, seven of whom had associated severe bronchial asthma. Supraventricular tachyarrhythmias were induced on occasion by bronchodilating agents such as beta-receptor agonists or theophylline preparations. High-dose steroids were required for acute bronchospasm in three patients, despite possibly leading to cardiac dysfunction. Beta-blockers therapy for Wolff-Parkinson-White syndrome can induce bronchospasm; in patients with Wolff-Parkinson-White syndrome and bronchial asthma, pharmacological agents used to treat one condition may exacerbate the other. Therefore, a non-pharmacological therapy was performed, namely surgical division of the accessory conduction pathway via an endocardial approach, in all seven asthmatic patients with Wolff-Parkinson- White syndrome. In all cases, division of the accessory conduction pathway resulted in disappearance of the delta wave, and there were no further tachyarrhythmias either at rest or after administration of bronchodilators. Since surgery, bronchial asthma has been effectively controlled with standard drug therapy in all patients. Non-pharmacological therapy is recommended for patients with Wolff-Parkinson-White syndrome and bronchial asthma.