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To the Editor In the excellent case presentation of a 46-year-old patient with stable, regular wide complex tachycardia (WCT) with a recent echocardiogram showing a structurally normal heart, Schuller et al1 describe the use of adenosine as a diagnostic tool for stable WCT. In their case, after adenosine administration the patient’s retrograde P waves disappeared and the WCT was not converted. This eliminated the possibility of supraventricular tachycardia (SVT) with aberrancy as a diagnostic possibility and confirmed the diagnosis of ventricular tachycardia (VT). According to the authors, “If the arrhythmia had terminated with adenosine use, or the atrial arrhythmia continued in the absence of ventricular conduction, the diagnosis of SVT with aberrancy would have been confirmed.”1(p1645)
Childers R. Diagnostic Value of Adenosine Conversion of Wide Complex Tachycardia. JAMA Intern Med. 2014;174(10):1705-1706. doi:10.1001/jamainternmed.2014.666