Pathologists are often confronted with cases of sudden cardiac death. The role of anatomical abnormalities or pathological lesions of the cardiac conduction system in sudden unexplained death has previously received insufficient attention. This is due, to a large extent, to the elusive, often inocuous nature of such lesions, the ostensibly normal life previously pursued by the patients, and the very particular physiological or metabolic state needed to impair normal conduction.

This text presents the findings of a series of over 100 examinations of the cardiac conduction system following sudden cardiac death, and aims to a enable readers to understand the nature of pathology and anatomical abnormality in the conduction system. The authors elucidate the role of these lesions in ventricular fibrillation and sudden death, with a view to stimulating research and thinking into new technogies to identify these anomalies in the living. This should ultimately shed light on the mechanisms of sudden death in the young and healthy, and potentially enhance the development of treatments.