To the Editor When patients are prone, it is common to perform an electrocardiogram (ECG) by placing the precordial electrodes on the patient's back, which transposes the usual location of the precordial electrodes to the dorsum (anatomical mirror). The case reported by Zhang et al 1 shows that a substantial anterior ST elevation can go unnoticed in the ECG recorded this way. In another article, based on a case series of 100 patients, Chieng et al 2 demonstrated the limited diagnostic capacity of the ECG obtained in this way, and specifically, showed this method is "unreliable for the detection of anterior myocardial injury."Based on the concept of the mirror image electrocardiogram, 3 we have proposed an alternative system for recording ECG in patients in the prone position. 4 According to the dipole theory, for each precordial point, there exists a corresponding point on the back (antipodal point). At this antipodal point, it is possible to obtain an identical ECG, albeit with opposite polarity and lower voltage. These antipodal points are located along an approximately straight path, extending from the left scapular line at the fifth intercostal level (corresponding to mirror V 1 ) to the right anterior axillary fold at the second intercostal level (equivalent to mirror V 6 ).Zhang et al 1 recommend reviewing the diagnostic criteria for acute ST-segment elevation myocardial infarction in the ECGs obtained from these patients. We propose the recording of precordial leads by positioning electrodes not on anatomical mirrors, but on electrical mirrors, and suggest recording with a calibration of 20 mm per mV. 4 Each precordial lead obtained in this manner closely resembles its corresponding lead, albeit inverted, and may hold important diagnostic value.