Sudden cardiac death (SCD) remains the principal cause of coronary heart disease (CHD) deaths. Therefore, studying SCD mechanisms, implementing new prognostic and preventive approaches are the main aims of modem cardiology. The review analyzes modern approaches to myocardial electrical instability correction and prognosis improvement in CHD patients. It has been proved that among all antiarrhythmics, beta-adrenoblockers only, and perhaps amiodaron, can reduce SCD incidence. Total mortality and SCD rate reduction has been demonstrated for ACE inhibitors, aspirin, statins, aldosterone antagonists. Recent clinical trials have proved that implanted cardioverters-defibrillators are more effective than pharmaceutical treatment in SCD prevention among high-risk patients.