[Contribution of the evidence-based medicine to the solution of some problems in electrocardiography]

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