Contribution of the Evidence-basedMedicine to the Solution of Some Problems in Electrocardiography

Overview

The paper summarizes the author‘s view on the possibilities to use the principles of evidence-based medicine forthe re-evaluation of classical hypotheses and formulation of new hypotheses in electrocardiology. Electrocardiographicdiagnostics of the left ventricular hypertrophy based on the voltage criteria, which is known to suffer byhigh number of so-called false negative results and low sensitivity, is shown as an example. An alternative approachis presented, based on the acceptation of these so-called false negative results as true results, reflecting changes inelectrical properties of myocardium due to electrophysiological remodeling in left ventricular hypertrophy. In thiscontext a new parameter is introduced for the quantification of the relative voltage deficit - the specific potential ofmyocardium. Results of experimental and clinical studies supporting the new paradigm are presented.

Key words:
electrocardiology, evidence-based medicine, left ventricular hypertrophy.