This commentary is inspired by the 12 year study of 133 type II diabetics (DM) in whom sudden cardiac death(SCD) risk was identified with one autonomic screening and addressed , reducing SCD 43% (p = 0.0076) [1], as well as studies identifying/treating autonomic markers of major adverse cardiac events( MACE) in congestive heart failure(CHF), HTN, and coronary disease(CAD)[2-6] resulting in improved outcomes. Since oxidative stress, and secondary dysautonomia, is a common thread of all major cardiac disease, and there is preventative/corrective therapy, a new paradigm of screening/treating oxidative-stress cardiac dysautonomia as a major common final pathway to MACE should be considered.