Following the arrhythmic index event, channelopathy patient should be reevaluated for risk stratification and prevention of recurrences. Expert centers with a focus on inherited arrhythmias should be involved in complex cases [4].

Atrial arrhythmias in low-risk patients could be managed in out-of-hospital setting with referral to arrhythmia experts to set up indication for pharmacological or non-pharmacological strategy. Thromboembolism should be managed according to AF guidelines using CHA₂DS₂VASC score [20]. First line therapy consists in avoiding potentially pro-arrhythmic drugs and conditions: a complete list should be supplied to the patient and to the general practitioner.

CPVT and LQT patients should be advised to limit/avoid competitive sport, strenuous exercise, and exposure to stressful environments (which in LQT2 should include exposure to loud/abrupt noises, i.e., alarm bell); Brugada patients should avoid excessive alcohol intake and large meals and should be advised to a prompt treatment of fever [45].

Aborted sudden death and sustained ventricular arrhythmias require an ICD for secondary prevention [4, 15, 31, 45] with or without adjunctive therapy.

CPVT and LQTS patients should be treated with beta-blockers: nadolol and propranolol are the drugs of choice [1, 4, 33]; in patients with recurrent symptoms/arrhythmias already on beta-blockers, it should be considered flecainide for CPVT patients [33] and flecainide or ranolazine or mexiletine in LQT3 patients [4]; ICD and left cardiac denervation should be considered in patients refractory to pharmacological therapy [4, 33]. Repeated exercise stress test is used in CPVT patients to evaluate drug efficacy.

Brugada and SQTS patients symptomatic for syncope should be treated with ICD; quinidine therapy could be used as adjunctive therapy or in cases in which ICD is refused or contraindicated or in recurrent appropriate ICD intervention [22, 26].

Hydroquinidine has proven to play a role in AF recurrence prevention in Brugada patients [4, 21].

Refractory electrical storm could be evaluated for catheter ablation of triggers [15, 39–41, 45].

All clinically diagnosed patients with LQTS and CPVT should undergo genetic evaluation if not previously performed, and it can be useful in Brugada (type1) patients and SQTS [42]. Routine genetic testing is not indicated for the survivor of an unexplained out-of-hospital cardiac arrest in the absence of a clinical index of suspicion for a specific cardiomyopathy or channelopathy [42] (Figs. 8.2 and 8.3)