**1. Introduction**

One of the most devastating life moments that may impact the whole life of persons, families and societies is the sudden death experience of a close relative or a beloved one. The whole medical provision is dedicated to prevent or delay death while maintaining good quality of life (QOL). For this reason, sudden loss of human life is creating the most serious challenge for medical professionals and decision makers. Sudden cardiac death (SCD) is defined as death occurring unexpectedly in the first hour after symptoms commence. In the United States, around 300,000 deaths occur every year because of SCD. It is conspicuous that this huge loss in the world communities is creating a major social impact. This impact is undoubtedly more destructive with the loss of a young member of the family. Sadly, life-threatening arrhythmias and sudden cardiac death can be the first presenting symptom. Scientists and clinicians were racing in the last two decades in a unique complementary scientific effort to reconcile the rapidly growing body of knowledge of the molecular mechanisms and clinical correlates of SCD. In this chapter, we will discuss the available risk stratification for channelopathies and detailed management steps with focus on the different trials for pharmaceutical approach of the different channelopathies. The electrical therapy in the form of ICD is a critical management step but will be prioritized according to channelopathy type and clinical settings. Future speculations of fatal ventricular rhythms are going to be discussed with special reference to solar and geomagnetic activity fluctuation and heart rate variability (HRV) correlations to SCD and the up to the moment knowledge in its impact on channelopathies.
