The effects of adenosine on idiopathic ventricular tachycardia

Our series is the largest to date on the use of adenosine triphosphate in patients with idiopathic VT. By utilizing the drug as a diagnostic tool to differentiate between reentry and triggered automaticity, we sought to identify the mechanisms prevalent in our population of patients, and observed a very good correlation between the mechanism of VT and its anatomic origin. The drug reproducibly terminated tachycardia in all patients except 1 with LBBB morphologic VT, an-d in no patient with RBBB morphologic VT. Our results strongly support the current view that VT of left ventricular inferoapical origin is primarily a reentry phenomenon, whereas VT of right ventricular outflow tract origin may be a heterogenous group in which the predominant mechanism is triggered automaticity.