Excerpt

We thank the authors of the letter to the editor for their interest in our recently published article [1] as well as for their valuable comments. We agree with the opinion of Chiale et al., that a shift in the intrathoracic heart position (for instance, occurring in pregnant women) can alter not only the cardiac axis but also the precordial transition. As a consequence, this might lead to a concealment of electrocardiographic features of Brugada syndrome. Therefore, it seems conceivable to record V₁ and V₂ in the intercostal spaces above the standard position. However, this is recommended not only for pregnant women. The alternative placement in a superior intercostal space is useful in all patients with a high clinical suspicion of Brugada syndrome who did not show a spontaneous type-1 Brugada-type ECG pattern [2]. Regarding the differences in ECG no. 1 and ECG no. 3, we have to keep in mind that different ECG patterns can be observed at different time points in the same patient [3, 4]. …