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This letter to the editor suggests that the reported high prevalence of ventricular tachycardia among wide QRS-complex tachycardia cases may be confounded by tertiary referral bias.
This letter to the editor discusses potential referral bias in a previous study concluding that ventricular tachycardia accounts for the overwhelming majority of wide QRS-complex tachycardias.
Letters and Corrections1 March 1989Wide QRS-Complex TachycardiaKeith D. Wrenn, MDKeith D. Wrenn, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-5-412_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:The article on wide QRS-complex tachycardia by Akhtar and colleagues (1) is a welcome treatise on the electrocardiographic diagnosis of this complex and often enigmatic arrhythmia. Although I agree with most of their conclusions, I must take issue with two points. First, that "ventricular tachycardia makes up an overwhelming majority of cases" is not definitively answered by a study made up of patients referred to cardiologists experienced in electrophysiologic evaluation. There is an inherent bias in this tertiary referral that cannot be easily explained away. Although this supposition may be correct, a large trial of consecutive patients...References1. Akhtar M, Shenasa M, Jazayeri M, Caceres J, and Tchou P. Wide QRS complex tachycardia: reappraisal of a common clinical problem. Ann Intern Med. 1988;109:905-12. LinkGoogle Scholar2. Wellens H. The wide QRS tachycardia [Editorial]. Ann Intern Med. 1986;104:879. LinkGoogle Scholar3. Lown B and de Silva R. Cardioversion and defibrillation. In: Hurst JW, Logue RB, Rackley CE, et al., eds. The Heart: Arteries and Veins. 6th ed. New York: McGraw-Hill Book Co.; 1986:1742-5. Google Scholar4. Steward R, Bardy G, and Greene H. Wide complex tachycardia: misdiagnosis and outcome after emergent therapy. Ann Intern Med. 1986;104:766-71 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Keith D. Wrenn, MDAffiliations: Emory University School of Medicine Atlanta, GA 30303 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWide Complex TachycardiaManagement strategies in wide QRS complex tachycardia 1 March 1989Volume 110, Issue 5 Page: 412-412 Keywords Arrhythmia Electrocardiography Electrophysiological techniques Tachycardia Ventricular tachycardia ePublished: 1 December 2008 Issue Published: 1 March 1989 PDF downloadLoading ...
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Keith D. Wrenn (1989) conducted a letter in Wide QRS-complex tachycardia. This letter to the editor suggests that the reported high prevalence of ventricular tachycardia among wide QRS-complex tachycardia cases may be confounded by tertiary referral bias.
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