Chronic heart failure (CHF) is a natural finale of all cardiovascular diseases. Its prevalence in Russian Federation (as assessed using traditional Framingham criteria) is 4.5% what corresponds to 5 million patients. Prognosis of decompensation of cardiac action remains unfavorable even at the background of optimal drug therapy and use of nondrug methods of treatment. Main causes of death of patients with CHF are cardiac decompensation and sudden cardiac death (SCD). In this review, we present analysis of Russian and foreign studies which have investigated immediate causes of SCD as well as methods of its primary and secondary prevention.