I appreciate the comments of Alves et al. I believe that they bring up an important point—that patients with other chronic supraventricular tachycardias will develop cardiomyopathies in addition to patients with atrial automatic foci such as we described. We have also seen patients with the Wolff-Parkinson-White syndrome and particularly with concealed retrograde conducting pathways who had chronic supraventricular tachycardia and who developed a cardiomyopathy that responded to successful treatment of the tachycardia. We have also seen patients with ventricular tachycardia respond in a similar way. I think the important point is that any tachydysrhythmia, if it is chronic, will lead to cardiomyopathy and should be treated aggressively.