In this article criteria for taking the history in patients with manifest or potential life threatening arrhythmias are outlined. The importance of a sound (family) history is demonstrated. Besides specific correlates for arrhythmias in the history of a patient, the long term consequences of dyspnoe on exertion and hypertension are outlined. In 80% of patients sudden death is due to myocardial ischemia or interstitial myocardial fibrosis which in turn result from acquired diseases such as coronary artery disease and hypertension. Against this background the importance of the prevention of sudden cardiac death by nonantiarrhythmics drugs is stressed. Examples of under-utilization of therapy guidelines are given with special reference to beta-blocker therapy.