Abstract

tion test may be of some value. In conclusion, Brugada syndrome is an uncommon condition responsible for SCD in Hong Kong. Patients who present with SCD associated with Brugada syndrome should be treated with an ICD, as recommended by the cardiology guidelines. However, with the current long term study results and an overall low incidence of SCD in Hong Kong, it is recommended that no further cardiac studies be performed on asymptomatic patients with Brugada ECG patterns since the positive predictive value of any risk stratifying test is extremely low (b10%). The management of patients with syncope is less clear. The current small cohort precludes us from drawing any definite conclusions. It appears that EP studies in this local population had very limited values in predicting future cardiac events. A possible explanation was that some patients suffered from neurocardiogenic syncope rather than arrhythmia related to Brugada syndrome. The generally benign course in our population certainly calls for further studies to define a better management strategy. Although our findings may not be applicable to other populations, one should keep in mind that the guidelines laid by the cardiology authorities may not be applicable to populations with a low prevalence of SCD.

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