Therapeutic and diagnostic efficacy of adenosine in wide-complex tachycardia

Wide-complex tachycardia is one of the most challenging problems faced by emergency physicians. Adenosine is an endogenous nucleoside that has gained recent popularity as an anti-arrhythmic drug in the setting of supraventricular tachycardia. We present the cases of two patients with stable wide-complex tachycardia in which adenosine was administered for therapeutic and diagnostic effects. Both patients quickly converted into sinus rhythm with subsequent diagnoses of atrioventricular reciprocating tachycardia secondary to Wolff-Parkinson-White syndrome. The role of adenosine in the acute management of wide-complex tachycardia is discussed.