Arrhythmias are common manifestations of heart disease which frequently cause sudden cardiac death (SCD) or other devastating health problems. In Europe, prevention of SCD by device and drug therapy is expensive and increasingly strains public health resources due to a growing population at risk. However, identification of patients at increased risk for SCD is ineffective, and SCD prevention strategies are not directed at the underlying risk mechanisms. To address this challenging situation, new insights into genetic and environmental modulators of SCD risk, arrhythmia initiating mechanisms (Triggers) and therapeutic strategies (Treatments) are urgently needed. The EUTrigTreat consortium proposes a translational project strategy based on interactive objectives (modules). Module 1 investigates novel genetic arrhythmia mechanisms in patients and is supported by Module 2 which investigates genetic and environmental SCD risk modulators in animals with arrhythmias. Module 3 elucidates common environmental arrhythmia risk mediators including obesity and diabetes. Module 4 applies molecular and biophysical imaging techniques to identify novel risk biomarkers. Module 5 translates experimental data through computer modeling and prediction analysis. Modules 6 develops new SCD risk identification strategies through combined patient and experimental studies. Module 7 develops and validates novel therapeutic drug compounds and a new form of anti-arrhythmic device therapy. The pre-clinical and clinical activities will potentially result in patents of diagnostic and therapeutic applications, licensing strategies, early clinical trials and a spin-off company. Module 8 manages, advises and reviews the project progress of EUTrigTreat. Ultimately, we aim to better understand and educate about arrhythmia initiating mechanisms and associated risk biomarkers. Such knowledge will provide strong rationales towards improved prevention and treatment of patients at risk for SCD.