**Acknowledgements**

The author acknowledges his great parents the late Abdulrhman Alabdulgader and Mariam Almulhim (with a blessing for her for a long peaceful life) who taught

*Sudden Cardiac Death*

**4. Summary**

cultures was examined. The application of 7.8 Hz, magnetic field of 90 nT was associated with gradual reduction in the spontaneous Ca++ transient amplitude. After 40 minutes of magnetic field application, 28% of the initial amplitude was reached. This reduction was associated with the calcium transient time gradually reduced. The effect is frequency dependent. The described changes occurred only in the 7.6–8 Hz. The frequency of 7.8 Hz is frequency of both central nervous system and cardiovascular system. It is the basic frequency responsible for the resonance between us humans as well as the biology on one hand and the cosmic environment on the other hand. The application of 7.8 Hz, magnetic field of 90 nT for 90 minutes results in the reduction of creatine kinase (CK) release to the buffer. This result was obtained during normal conditions, hypoxic environment and use of 80 μM H2O2 to induce oxidative stress. It sees that the first range of ScR has an effect on cardiac cell characterized by CK release reduction as a stress response and this effect is of a protective effect [103]. Magnetic field dynamics could add to our future understanding of the SGMA interaction with human heart in health and disease. The known transmembrane pacemaker protein CHN4, present in both sinoatrial and AV nodal cells, could interact with field information to provide specificity in an electronic key-to-lock mechanism interaction [104]. It is conspicuous that the near future is carrying more details to disclose the true pathomechanism of how modulation of HRV with fluctuation of SGMA can trigger the fatal rhythms and sudden death. More intelligent preventive as well as therapeutic strategies will be then available.

Risk stratification for LQTSs is available with high correlation to positive genetic testing with 75% likelihood if the score is more than 4 points. Half of LQTS cases prove positive mutation. This is not the case with other channelopathies where paucity of positive mutations is the role. Beta blockers (propranolol and nadolol than metoprolol) are the first-line and easiest therapeutic choice for both LQT1 and LQT2. There is no scientific evidence favoring selective over non-selective beta blockers. It is always advised to keep beta blockers as adjunct treatment after ICD implants. In the current medical literature, there is controversy regarding the use of beta blockers in LQT3. Scientific evidence is suggesting significant therapeutic role of sodium channel blockers like ranolazine, mexiletine and flecainide in LQT3 treatment. Mexiletine was proved also of being an effective therapeutic option in LQT3 as well as LQT1 and LQT2. In the absence of concomitant gene mutations, epinephrine and isoproterenol were found to be effective in acquired LQTS. The implantation of an ICD is pivotal secondary prevention in LQTS and a reasonable primary prevention approach in selected cases. Surgical therapy in the form of left cardiac sympathetic denervation (LCSD) is a well-accepted treatment option in LQTS patients. It is an option in selected cases like LQT1 and LQT2 patients with no proper response to beta blockers, intolerance to beta blockers, or after ICD implant with recurrent arrhythmias. Aggressive management of febrile illnesses as well as avoidance of drugs inducing VT/VF is critical in BrS arrhythmia patients. Isoproterenol intravenously is used with success to control VF storms in BrS. ICD implant is a must for secondary prevention but is guarded in primary prevention especially in asymptomatic individuals. In case of frequent ICD shocks, quinidine can be used as adjunct treatment (up to 600 mg a day). Ablation of the anterior aspect of RVOT seems a promising and successful option in BrS patients. In PCVT, high doses of nadolol (3–5 mg/kg) may be necessary to suppress exertional ectopy. Because of the high risk of recurrent events and SCD on β-blockers, adjunctive ICD implantation is recommended in all PCVT symptomatic patients. Physicians must

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him the mercy and gratitude to his society, human species and all biology in large. The author's special praise goes to his brother Khalid who shared his scientific life journey until dreams became reality.
