Determining ECG Parameters for Electrical Risk Score in Patients with Non-ST Elevation Myocardial Infarction

In the present study, the authors reported that the frequency of adverse events and mortality was significantly higher in NSTEMI patients with an electrical risk score (ERS) 3 at admission.We would like to emphasize some important points about this well-written study.First, the authors defined left ventricular hypertrophy (LVH) according to the Sokolow-Lyon criteria.However, the Cornell criterion (S wave in V 3 + R wave in aVL 28 mm in men or 20 mm in women) is the most sensitive and specific LVH criterion. 2In addition, the authors reported that the QT interval was measured from the beginning of the QRS complex to the end of the T wave and obtained from the automatic report of the ECG device.The QT interval measurement using the end of the T wave may overestimate the QT interval.Instead, a line is drawn across the maximal T wave downslope, using the last T wave peak.The intersection of this line with the baseline is used to calculate QT interval (Figure 1). 2 Many medical doctors use the QT interval and QTc value that are automatically provided by ECG records in daily practice.Neumann et al 3 reported that automatic and manual QT interval and QTc values could be highly conflicting and concluded that automatic measurements require manual confirmation in order to obtain reliable results.Finally, as with Tp-e interval measurement, measuring differences of a few milliseconds without a software is quite difficult and error prone.Can we kindly ask