Life expectancy is increasing even though life span is fixed. There will be almost 35 million Americans over 65 years of age in the year 2030. CAD will account for almost 80% of the deaths in the population with almost 50% of such deaths classified as sudden. Ventricular arrhythmias increase with age and have been shown to be independent markers for premature cardiac death. Therefore, many trials involving the use of antiarrhythmics have been performed, hoping to show an improvement in overall survival. Unfortunately, some of the classical antiarrhythmic agents despite markedly suppressing the arrhythmias, have been shown to be harmful or of no benefit. The use of b-blockers, amiodarone, aspirin, and ACE inhibitors show some potential for benefit in this high risk patient population. The implantable devices are superior to antiarrhythmics in survivors of cardiac arrest.