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This editorial refers to ‘Sudden cardiac death in 14- to 35-year olds in Ireland from 2005 to 2007: a retrospective registry’ by R. Margey et al., on page 1411. From a societal perspective it is difficult to reconcile the occurrence of sudden and unexpected deaths among our young, especially in ostensibly healthy and active individuals with no prior warning. Even today, we must acknowledge that these situations also present a significant challenge to the clinician as well as the scientist, particularly since many of these cases remain unexplained. The paper from Margey et al .1 published in the current issue of Europace is one among a series of reports highlighting the conspicuously large subgroup of cases with sudden death and structurally normal heart in the young, also termed the sudden arrhythmic death syndrome. The authors, reporting results from a national retrospective post-mortem analysis of sudden cardiac deaths (SCDs) in the 15–34 years age group in the Republic of Ireland, have done justice to comparisons with existing studies. However, there is room for a brief conversation regarding two important messages from their findings as well as a comment on the methodology used to perform the …

Approach to unexplained sudden death in the young: proactive during life and prospective at death