THE BRUGADA-SYNDROME IN A CHINESE POPULATION

Sudden cardiac death has been reported in patients with a unique elect rocardiographic (ECG) abnormality showing right bundle branch block an d ST segment elevation in the precordial leads. This syndrome was firs t described by Brugada and Brugada and has not been previously describ ed in a Chinese population. We report here the first three cases in Si ngapore. The first patient was a 49-year-old man who presented with sy ncope, associated with generalized convulsions. The second patient was a 25-year-old man who complained of palpitations but no syncope. The third patient was a 77-year-old man who presented with recurrent episo des of syncope and collapsed with ventricular fibrillation. All patien ts had no past cardiac or drug history of note. The neurological exami nation and investigations were normal. All three patients showed a uni que right bundle branch block pattern with ST segment elevation in lea ds V1-3. The echocardiogram and 24-h ambulatory ECG monitoring, were n ormal. Single vessel disease was present in the third patient. Electro physiological studies performed in all three patients were able to ind uce ventricular fibrillation. The patient with resuscitated cardiac de ath underwent an implantable cardioverter defibrillator implantation. The importance of this syndrome is that the recognition of the unique ECG pattern enables early identification and treatment of these patien ts. (C) 1998 Elsevier Science Ireland Ltd.