What are the indications for referring a patient with suspected Brugada Syndrome to a cardiologist?

Refer a patient with suspected Brugada Syndrome urgently to a cardiologist if they have any of the following features: a history of syncope or near syncope, a family history of sudden cardiac death under the age of 40 years, or ECG abnormalities suggestive of Brugada Syndrome (such as ST segment or T wave abnormalities, or conduction abnormalities including right bundle branch block patterns). Additionally, urgent referral is indicated if there is evidence of high-risk arrhythmias such as ventricular tachycardia or high-degree atrioventricular block on ECG. Routine referral is appropriate if there are accompanying symptoms such as chest pain, lightheadedness, or if there is a history or signs of structural heart disease or hypertension. If palpitations are isolated with a normal ECG and no high-risk features, referral may not be necessary. However, any suspicion of ventricular arrhythmias or frequent ventricular extrasystoles warrants cardiology assessment. The urgency of referral depends on clinical judgement based on these features.