In Reply We are in agreement that adenosine-sensitive ventricular tachycardia (VT) is a possibility. Various idiopathic VTs, including outflow tract and fascicular VTs, can terminate with adenosine administration.1 Hence, termination of the tachycardia with adenosine alone would not be diagnostic, and other considerations, including the electrocardiogram and clinical situation, should be taken into account to help make the diagnosis. Finally, if an atrial arrhythmia continued without ventricular conduction due to atrioventricular block secondary to adenosine use, this would be confirmation of supraventricular tachycardia.
Schuller JL, Varosy PD, Nguyen DT. Diagnostic Value of Adenosine Conversion of Wide Complex Tachycardia—Reply. JAMA Intern Med. 2014;174(10):1706. doi:10.1001/jamainternmed.2014.653