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Utilization of advanced information, telecommunication and implant technology for cardiac risk stratification and management is one of the greatest challenges for modern health care provision. Sudden cardiac death is the major contributor to overall cardiovascular mortality with approximately 60% of all coronary heart disease fatalities occurring annually. Although some high-risk patient groups have been identified with reasonable sensitivity and specificity based on statistical evaluation, it is still not possible to assess the acute risk of individuals. Implants like cardiac pacemakers with telemetric capability offer the possibility for continuous, permanent surveillance. Hence, advanced technology renders possible a new systematic approach with the aim to identify high-risk individuals, to support the initiation of appropriate therapy management and to prevent the occurrence of sudden death. First results obtained from heart transplant patients, patients after myocardial infarction, and patients with coronary risks render possible the assessment of presently available technology and reveal the potential of cardiac telemonitoring as an emerging field.