Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.

Department of Exercise Medicine and Cardiovascular Rehabilitation University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Internal Medicine 1 Cardiology University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

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