<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><SPAN lang="EN-US">Dear Dr. Alejandra Guerchicoff, Dr. Guido D. Pollevick, Dr. Charles Antzelevitch:<BR> I have a question, this is the problem I met in clinical practice last year. If the one who was found having mutation, but he or she did not want to tell his or her spouse, how shall we do? All the family members have been screened, and every one want know the result.<BR> Sincerely Yours<BR> Wenling Liu from Beijing Univ.People's Hosp.<O:P></O:P></SPAN><DIV><BR><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px 0px; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; text-align: auto; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">--</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Sergio<SPAN class="Apple-converted-space"> </SPAN>Dubner</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Scientific<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; ; font-family: Lucida Grande; font-size: 13px; "><BR style="font-family: Lucida Grande; font-size: 13px; "></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Edgardo<SPAN class="Apple-converted-space"> </SPAN>Schapachnik</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Steering<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV><BR class="khtml-block-placeholder"></DIV></SPAN></DIV><DIV><DIV><BR class="khtml-block-placeholder"></DIV><DIV><BR class="khtml-block-placeholder"></DIV><BLOCKQUOTE type="cite"><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; min-height: 14px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr. Leonid Makarov from Russia asks</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; min-height: 14px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">- What patients have indication for molecular genetic studies? In the case of detection of genetic mutations, characteristic for short or long QT syndrome, Brugada syndrome, Arrhythmogenic Right Ventricular Dysplasia, would it be ethical to inform all patients about these findings?</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; min-height: 14px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr. Alejandra Guerchicoff, Dr. Guido D. Pollevick and Dr. Charles Antzelevitch answer</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">- Genetic tests are done to confirm a suspected diagnosis in a proband with clinical signs and symptoms of the disease, to predict the possibility of future illness in family members, to detect the presence of a carrier state in unaffected individuals (whose children may be at risk), and to predict the response to therapy or qualify a patient for gene-specific therapy, particularly in syndromes such as long QT syndrome. Genetic testing is also critically important to advancing research aimed at better diagnosis and treatment of the syndrome. Genetic tests involving the channelopathies you mention are best done under the supervision of an electrophysiologist, ideally with the assistance and support of a certified genetic counselor.<SPAN class="Apple-converted-space"> </SPAN></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Receiving test results can be an emotional experience and the collaboration of the physician with a genetic counselor can help guide the patient and his/her family through a difficult time and assist with decisions as to whether extend the test to other family members.<SPAN class="Apple-converted-space"> </SPAN></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Privacy issues are paramount in any discussion involving notification of patients of the results of genetic testing. All patients tested must give informed consent before the test can be carried out. In so doing, they can elect to be notified of the results or not. Their individual rights must be respected. Most countries have laws that protect the privacy of individuals undergoing genetic testing, preventing release of the results to anyone without specific, written consent from the patient.</DIV></BLOCKQUOTE></DIV><BR></DIV></BODY></HTML>