Dynamic parameters of ventricular repolarization as Holter derived parameters expressed as QT-interval adaptation to heart rate changes (QT/RR-slope) and QT-interval-variability are being more and more frequently used to identify patients with increased risk for ventricular arrhythmias. Steep QT-RR-slopes, reflecting inadequate adaptation of ventricular repolarization to heart rate changes, as well as increased QT-interval-variability, reflecting temporal inhomogeneity of ventricular repolarization duration, are frequently observed in patients at risk for sudden cardiac death. Additionally, there is strong evidence for significant alterations in the dynamics of action potential duration restitution in patients with structural heart disease. This review gives an up-to-date overview about the current research in methods of assessment and clinical relevance of dynamic parameters of ventricular repolarization.