Duodromic tachycardia: A case report of a rare presentation of wide complex supraventricular tachycardia

Key Teaching Points•A presenting wide complex tachycardia carries a broad differential, and an organized approach can elucidate the mechanism.•Subtle electrocardiographic changes following adenosine and cardioversion may provide evidence for rare and unique reentry mechanisms.•Electrophysiology study maneuvers can be used to differentiate complex reentrant arrhythmia mechanisms. •A presenting wide complex tachycardia carries a broad differential, and an organized approach can elucidate the mechanism.•Subtle electrocardiographic changes following adenosine and cardioversion may provide evidence for rare and unique reentry mechanisms.•Electrophysiology study maneuvers can be used to differentiate complex reentrant arrhythmia mechanisms.