TED FELDMAN, M.D.
To the editor: The caveats regarding initial therapy for wide QRS complex tachycardia presented by Stewart and coworkers (1) and the companion editorial (2) on diagnosis and therapy in the June issue are clear and pragmatic. Both articles emphasizethe importance of atrioventricular dissociation in the differential diagnosis of wide QRS tachycardia; atrioventricular dissociation is the hallmark of ventricular tachycardia. However, neither article mentions esophageal or atrial electrocardiography as a diagnostic aid for evaluation of the atrioventricular relation in patients with wide QRS tachycardia.
In most patients, when the surface 12-lead electrocardiogram fails to show the presence or absence of atrioventricular
FELDMAN T. Atrial Electrocardiography for Diagnosis of Wide QRS Tachycardia. Ann Intern Med. ;105:462. doi: 10.7326/0003-4819-105-3-462_1
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Published: Ann Intern Med. 1986;105(3):462.
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