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Comment & Response |

Diagnostic Value of Adenosine Conversion of Wide Complex Tachycardia—Reply

Joseph L. Schuller, MD1,2; Paul D. Varosy, MD1,3; Duy Thai Nguyen, MD1
[+] Author Affiliations
1Department of Medicine, University of Colorado, Aurora
2Denver Health Medical Center, Denver, Colorado
3VA Eastern Colorado Health Care System, University of Colorado, Colorado Cardiovascular Outcomes Research (CCOR) Group, Denver
JAMA Intern Med. 2014;174(10):1706. doi:10.1001/jamainternmed.2014.653.
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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.


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October 1, 2014
Richard Childers, MD
1Naval Hospital Guam Emergency Department, Agana Heights, Guam
JAMA Intern Med. 2014;174(10):1705-1706. doi:10.1001/jamainternmed.2014.666.
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