Cardiac myocytes normally initiate action potentials in response to a current stimulus that depolarizes the membrane above an excitation threshold. Aberrant excitation can also occur due to spontaneous calcium (Ca 2+ ) release (SCR) from intracellular stores after the end of a preceding action potential. SCR drives the Na + /Ca 2+ exchange current inducing a "delayed afterdepolarization" that can in turn trigger an action potential if the excitation threshold is reached. This "triggered activity" is known to cause arrhythmias, but how it is initiated and terminated is not understood. Using computer simulations of a ventricular myocyte model, we show that initiation and termination are inherently random events. We determine the probability of those events from statistical measurements of the number of beats before initiation and before termination, respectively, which follow geometric distributions. Moreover, we elucidate the origin of randomness by a statistical analysis of SCR events, which do not follow a Poisson process observed in other eukaryotic cells. Due to synchronization of Ca 2+ releases during the action potential upstroke, waiting times of SCR events after the upstroke are narrowly distributed, whereas SCR amplitudes follow a broad normal distribution with a width determined by fluctuations in the number of independent Ca 2+ wave foci. This distribution enables us to compute the probabilities of initiation and termination of bursts of triggered activity that are maintained by a positive feedback between the action potential upstroke and SCR. Our results establish a theoretical framework for interpreting complex and varied manifestations of triggered activity relevant to cardiac arrhythmias.calcium wave | delayed afterdepolarization | triggered activity | bistability | arrhythmias V entricular arrhythmias, the leading cause of sudden death (1), tend to occur unexpectedly. Understanding their initiation mechanisms remains a major challenge for clinical cardiologists (2). Lethal arrhythmias can occur without any abnormal sign in the ECG, or can be preceded by multiple premature ventricular complexes (PVCs) or short runs of ventricular tachycardia (3). There are many possible sources of randomness that can be responsible for the seemingly unpredictable nature of arrhythmias, such as environmental stresses via neural or metabolic regulations, chaotic dynamics (4, 5), or fluctuations associated with the intrinsic stochasticity of ion channel kinetics (6, 7).During normal contraction, calcium (Ca 2+ ) release from the sarcoplasmic reticulum (SR)-the intracellular Ca 2+ store of a ventricular myocyte-is triggered by Ca 2+ entry into the cell via L-type calcium channels (LCCs), a mechanism known as Ca 2+ -induced Ca 2+ -release (CICR). However, SR Ca 2+ release can also occur spontaneously, as observed in a variety of pathological conditions ranging from heart failure (8, 9) to ischemia (10) to catecholaminergic polymorphic ventricular tachycardia (11)(12)(13)(14). Spontaneous Ca 2+ release (SCR) transi...