In reply:

We appreciate the letter to the editor from Dr. deSouza,1 who astutely points out that certain symptomatic supraventricular tachycardia arrhythmias such as atrioventicular nodal reentrant tachycardia or atrial tachycardia have considerably less morbidity than other supraventricular tachycardia arrhythmias such as atrial fibrillation or atrial flutter in older adults with syncope. We are in agreement that not all supraventricular tachycardia arrhythmias are created equal. This is notable because the majority of serious cardiac arrhythmias identified after emergency department (ED) evaluation in our study were supraventricular tachycardia arrhythmias (42/102; 40%).

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