Myocardial ischemia is a cause of sustained poly- morphic VT/VF, and revascularization is an effec- tive treatment to prevent myocardial ischemia. For patients with life-threatening VA, observa- tional studies show that patients undergoing coronary artery bypass graft (CABG) had substan- tially better survival after accounting for other The risk of SCD appears compara- ble for patients with complex ischemic heart disease For patients with low LVEF and ischemic heart disease amenable to CABG, the risk of SCD is lower with CABG than medical therapy.S5.5-2,S5.5-7 Observational studies show an association between a lower likelihood of death with revascularization for survivors of SCA and CABGS5.5-3 Revascularization alone is usually insufficient to prevent recurrence of sustained monomorphic VT; further evaluation for inducible VT is generally con- sidered if ventricular function is depressed and/or scar is present. 2. Anomalous aortic origin of the coronary arter- ies is detected in approximately 1% of patients undergoing routine coronary angiography, and <0.2% of children and adolescents under- Although ischemic heart disease is detected in as many as 24% to 55% of SCD cases in young patients <35 years anomalous aortic origin of the coronary arteries is an important cause of SCD in the young, reported in 10% to 17% of patients included in postmortem studies.S5.5-10,S5.5-11 Anomalous origin of the coronary arteries can be identified by echocardiography, invasive coronary angiography, CT angiography or cardiac MRI. In patients with SCA or life-threatening VA presumed CLINICAL STATEMENTS AND GUIDELINES related to ischemia caused by anomalous origin of a coronary artery, repair or revascularization is performed to alleviate ischemia and reduce the recurrence of VA.S5.5-6,S5.5-7,S5.5-12 S5.5-14 5.5.1. Surgery for Arrhythmia Management Recommendation for Surgery for Arrhythmia Management References that support the recommendation are summarized in Online Data Supplement 12. 