(A) Comprehensive clinical, electrocardiographic, and genetic overview of the various diseases associated with VA or SCD as reported in the 2022 ESC Guidelines for VA and SCD.1 The VA/SCD Guidelines provide many updated recommendations for the management of patients with congenital heart disease, idiopathic VF, acquired Long QT, Brugada and early repolarization syndrome, as well as catecholaminergic polymorphic VT, and short QT syndrome. (B) From the same Guidelines, an algorithm for the management of sustained monomorphic ventricular tachycardia in patients with chronic coronary artery disease.1 The algorithm also holdsin partfor non-ischaemic pathologies. Note, the new VA/SCD Guidelines promote VT ablation significantly. It may e.g. be performed to ameliorate or avoid ICD therapy, or to enhance resynchronization therapy by ablation of frequent monomorphic PVCs (extrasystolopathy). The trials PARTITA, PAUSE-SCD, and SURVIVE-VT, discussed in the present paper, all strengthen the recommendations for application of catheter ablation.57 (C) Exercise causes downregulation of genes coding intercalated disk proteins, as well as scaffolding and ion channel proteins, both in normal mice and PKP2 conditional knockouts. Consistent with PKP2-dependent muscle mass deficit, cardiac dimensions in human athletes carrying PKP2 mutations were reduced (data not shown), compared with matched controls. Exercise challenges a cardiomyocyte desmosomal reserve which, if impaired genetically (e.g. Plakophilin2 loss), can cause accelerated progression of the cardiomyopathy.3 Reprinted with permission.