Sudden cardiac death due to ventricular fibrillation is the leading cause of fatality in the industrially developed world. A considerable body of evidence indicates that the higher nervous system modifies electrical activity of the heart and may trigger sudden death. The evidence for increased risk for ventricular fibrillation due to psychophysiologic factors is supported predominantly by animal studies, but increasing evidence is forthcoming from human studies. The involvement of psychiatrists, psychologists, and cardiologists in a multidisciplinary approach to managing patients at risk for sudden death from ventricular fibrillation is yielding significant insights and prolonging their lives.