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1. Introduction Administration Heart Failure Trial) and other trials suggest that death is disproportionately sudden in patients with Over 2 million Americans suffer from heart failure and more modest myocardial dysfunction [8]. A major caveat more than 200 000 die annually. The incidence is esti- is that the mechanism of sudden death is highly heterogemated to be 400 000 per year with a prevalence of over 4.5 neous; even if one considers only those patients with death million, numbers that will increase with the aging of the due to a tachyarrhythmia, several mechanisms may prevail. US population [1]. Despite remarkable improvements in This review will consider the cellular electrophysiologimedical therapy the prognosis of patients with myocardial cal changes that have been observed in myocardial hyfailure remains poor with over 15% of patients dying pertrophy and failure that predispose to cardiac arrhythwithin …