We thank Dr. Karakus et al. for their interest in our recently published paper assessing the usefulness of electrocardiogram recordings in the high intercostal space to identify the risk of sudden death. (Hasegawa et al., 2020) In their letter to the editor, they expressed two concerns about the findings of our study. First, they suggested the need to include clinical data of modular factors including age, heart rate, electrolyte imbalance, hyperthermia, and usage of pharmacological agents on analysis for making clear the relationship between J point elevation in high precordial leads and ventricular fibrillation. These factors could influence the development of ventricular fibrillation in J wave syndrome, (Antzelevitch et al., 2017) and we agree with the importance of considering their influences. However, in our cohort, there was no patient showing abnormalities in electrolytes or body temperature. Regarding medications, as described in our paper, only two patients with Brugada syndrome received antiarrhythmic drugs, but in other ones did not have any drugs that can affect the J wave. We showed that there is no difference in the baseline heart rate in each group. Therefore, we subjected the other factors including J point elevation in the 3rd intercostal spaces, age, and sex at diagnosis to Cox proportional hazard analysis followed by stepwise forwards and backward regression modeling. We found that J point elevation in the 3rd intercostal spaces was significantly associated with the development of ventricular fibrillation in the patients with idiopathic ventricular fibrillation, as shown in the Table 1.

Second, Karakus et al. pointed out the problems of the statistical measurement methods regarding the skewness in our cohort and the comparison between the three groups. We had confirmed that all of the parameters in three groups were normally distributed and used one-way ANOVA for the comparisons.

我们感谢 Karakus 博士等人。因为他们对我们最近发表的论文感兴趣，该论文评估了高肋间空间心电图记录在识别猝死风险方面的有用性。(Hasegawa et al., 2020 ) 在给编辑的信中，他们表达了对我们研究结果的两个担忧。首先，他们建议需要将包括年龄、心率、电解质失衡、体温过高和药物使用在内的模块化因素的临床数据纳入分析，以明确高心前导联 J 点抬高与心室颤动之间的关系。这些因素可能会影响 J 波综合征心室颤动的发展，（Antzelevitch 等，2017) 并且我们同意考虑其影响的重要性。然而，在我们的队列中，没有患者出现电解质或体温异常。关于药物，如我们的论文所述，只有两名 Brugada 综合征患者接受了抗心律失常药物，但其他患者没有任何影响 J 波的药物。我们发现每组的基线心率没有差异。因此，我们将其他因素包括第 3 肋间的 J 点抬高、年龄和诊断时的性别进行 Cox 比例风险分析，然后逐步向前和向后回归建模。

其次，Karakus 等人。指出了我们队列中偏度的统计测量方法以及三组之间的比较存在的问题。我们已确认三组中的所有参数均呈正态分布，并使用单向方差分析进行比较。