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In recent years it has become evident that myocardial tissue undergoes remodeling in disProf. Dr. Andr6 G. Kleber (N~) Vladimir Fast Department of Physiology University of Bern Btthlplatz 5 3012 Bern, Switzerland eased states such as myocardial infarction and hypertrophy which affects membrane channels, cell-tocell coupling as well as the connective tissue matrix. Although the detailed mechanisms of ventricular arrhythmias in ventricular hypertrophy are not known, studies carried out by computer simulations or high resolution mapping of electrical activity have suggested a complex interaction between changing ionic currents at the level of the cell membranes, altered cell-to-cell coupling and altered macroscopic structure. The present report summarises these recent developments and their potential relevance for arrhythmogenesis.