In Reply We thank Chen-Scarabelli and Scarabelli for their interest in our study.1 We acknowledge that our study lacks data on the causes of syncope and cannot estimate risk attributable to specific causes of syncope. Our study was based on hospital International Classification of Diseases diagnosis codes, which do not specify the etiology of syncope. Many cases of syncope remain of unknown origin, however, and clinicians will still need to evaluate patient fitness to drive after an episode of syncope. Our study of a nationwide cohort of 41 039 adult patients with a primary discharge diagnosis of syncope is representative of the most common clinical presentations of syncope.2