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Is it important to determine whether patients with paroxysmal supraventricular tachycardia have a participating accessory pathway? Dr Caruso says yes, for a number of reasons, including the possibility that atrial fibrillation in such patients may easily deteriorate into ventricular fibrillation. Moreover, if an accessory pathway is present but not suspected, a patient may be given drugs that enhance this threat. Adenosine is currently preferred to treat both orthodromic atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia.