In Reply We thank Dadehjani and colleagues for their thoughtful comments on our proposal to use a His-ventricular (HV) interval 65 or more milliseconds to guide prophylactic pacing in myotonic dystrophy type 1 (DM1). Their letter usefully highlights a point that is fundamental to all diagnostic and prognostic prediction, and not specific to our study.
For any continuous marker, changing the decision threshold inevitably trades sensitivity against specificity. Dadehjani and colleagues’ suggestion of a higher threshold call for 3 considerations.
JAMA Cardiology published a clinical update in Cardiology on 01 Apr 2026.
The item focuses on A New His-Ventricular Threshold for Myotonic Dystrophy Type 1—Reply.
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