[SCD-FORUM] 65E ECG predictors of SCD. Dr. Madias

[SCD Symposium]

Dear colleagues:

Greetings!!!

Big Ccongratulations to the Organizers (!!!), for this magificent
symposium, a scientific interaction, to which we have started becoming
addictive.

Regarding the comment of Dr. Andriy Vorotniak, on the "palpitations"
and Brugada syndrome, and his suggestion that we should work toward
compiling a list of ECG predictors of SCD, for us cardiologists and
physicians working in the ambulatory medicine setting, I am afraid that
many od such criteria may turn out to have a low sensitivity for SCD.
Besides, we have not as yet resolved the problem of the marked
variability in the precordial component of serial ECGs of individual
patients, as it is apparent nowadays in hospital elecronic ECG files.
Routine perusal of serial ECGs of patients evaluated in "consult rounds"
discloses massive differences from ECG to ECG in the amplitude and
morphology of V1-V6 leads. How one could rely on ECG predictors of SCD
(often depending on the precordial leads) when the eproducibility is so
poor? In addition experience has alrready been published that for
Brugada stndrome the characteristic type I pattern was seen in some
patients only when, other than the conventional V1-V3) thoracic
electrode positioning was employed, something not expected to be
available in routine standard ECG recordings. I beleive we should start
from insisting that the ECGs obtained in ALL our patients are recorded
appropriately, so that at least we resolve the problem of the poor
reproducibility in serial ECG recordingsin the same patients. This is a
prerequisite befoer we start delving into the matter of "ECG predictors
of SCD".

   Warmest Regards to ALL

Sincerely,

John E. Madias, MD, FACC, FAHA,
Professor of Medicine (Cardiology)
Mount Sinai School of Medicine
of the New York University,
Cardiology Division,
Elmhurst Hospital Center
e-mail::madias at nychhc.org

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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