Honoring a Mentor: The Sound of Silence and its Echo in JACC – A Personal Reflection

In the May 2026 issue of JACC: Case Reports, I presented an intriguing ECG challenge titled “The Sound of Silence and its Echo.” The case explores a fascinating electrophysiologic phenomenon in which a premature atrial complex reaches the sinus node while it is still largely refractory. Under specific conditions, the impulse may slowly penetrate a small peripheral zone of earlier recovery, remain transiently confined, and later exit to re-excite the atrium, producing an early sinus P wave suggestive of sinus echo.

I would also like to publicly acknowledge that the ECG presented in this paper was courtesy of Dr. Alfonso Tolentino.

Dr. Tolentino is someone for whom I have profound admiration, enduring respect, and immense gratitude—not only as an exceptional ECG educator and mentor, but also as a father figure whose guidance has deeply influenced both my academic and personal journey.

Over the years, we have collaborated on several academic and educational projects, including the chapter “Long QT Syndrome Type I” in the Spanish-language ECG textbook published this year by Editorial Distribuna, Volume II of EKGDX, and several articles in prestigious journals such as Circulation and JACC.

These collaborations reflect our shared passion for electrocardiography and our commitment to ECG education beyond publications, academic recognition, or professional achievement.

Finally, I would like to offer my sincere apologies for unintentionally omitting the acknowledgment “Courtesy of Dr. Alfonso Tolentino” in the published paper. This omission was entirely inadvertent, and I deeply regret the oversight.

Thank you, Alfonso, for your mentorship, generosity, friendship, and unwavering dedication to teaching.

With profound respect and gratitude.

Albert Roig