Brugada syndrome was potentially first seen on EKG in survivors of cardiac arrest in 1989, but it was not until 1992 that the Brugada brothers recognized it as a distinct clinical entity which could cause sudden death by ventricular fibrillation.

• Sudden unexplained death syndrome was first noted in 1977 by Hmong refugees in the US.^[1][2]
• The disease was again noted in Singapore, when a retrospective survey of records showed that 230 otherwise healthy Thai men died suddenly of unexplained causes between 1982 and 1990: publication of this data provoked a diplomatic incident.^[3]
• The condition appears to affect primarily young Hmong men from Laos (median age 33) and northeastern Thailand (where the population are mainly of Laotian descent).^[4][5]
• There is a strong hereditary component and the victims tend to die in their sleep. Survivors describe a feeling of intense fear and paralysis. There is a sensation of pressure in the chest, the presence of an alien being in the room and altered sensation.^[6]
• This phenomenon is well known among the Hmong people of Laos, who ascribe these deaths to a malign spirit, dab tsog (pronounced “da cho”), said to take the form of a jealous woman. Hmong men may even go to sleep dressed as women so as to avoid the attentions of this spirit.^[7]
• The Brugada brothers were the first to describe the characteristic ECG findings and link them to sudden death. Before that the characteristic ECG findings were often mistaken for a right ventricular myocardial infarction. In 1953 a publication by Oscher mentioned that despite being mistaken for right ventricular myocardial infarction, the ECG findings were not associated with myocardial ischemia.^[8]
• Although the ECG findings of Brugada syndrome were first reported among survivors of cardiac arrest in 1989, it was only in 1992 that the Brugada brothers recognized it as a distinct clinical entity, causing sudden death by causing ventricular fibrillation.^[9][10]

Cardiology