Ischaemic heart disease is the main cause of death. Most of these deaths are sudden and occur within the first few hours of onset of symptoms and before the patient reaches the hospital. It is generally accepted, that sudden death is due to ventricular fibrillation. The aim of this presentation is to review the studies of long-term antiarrhythmic therapy and beta-blockade in the prevention of sudden cardiac death. Studies, in which a given antiarrhythmic drug was routinely applied, have universally failed to show any protective effect. However, when effective patient specific drugs are selected during programmed ventricular stimulation, long-term treatment in high risk patients may be beneficial. Recently suggestive evidence has been presented, that long-term beta-blockade is beneficial in preventing sudden death and reducing overall mortality in ischaemic heart diseases although the antiarrhythmic properties of beta-blockers are relatively weak.