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Table 1 Indications for ICD implantation in HCM patients to prevent SCD

From: Synchronous cardiac arrest in monozygotic twins with hypertrophic cardiomyopathy - Is sudden cardiac death genetically pre-programmed?

ICD Recommended (Class I)

ICD Reasonable (Class IIa)

ICD May be Useful (Class IIa)

Prior cardiac arrest

Family history of sudden death in first degree relative (age <50)

Non-sustained VT or abnormal BP response in presence of other SCD risk modifiers.

Sustained VT

LV wall thickness ≥ 30 mm

Note: Role of ICD is uncertain in non-sustained VT or abnormal BP response in absence of other SCD risk modifiers (Class IIb)

Recent unexplained syncope

  1. Modified from Gersh BJ, Maron BJ, Bonow RO et al. 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124: e783-e831.
  2. (ICD = implantable cardioverter-defibrillator; HCM = hypertrophic cardiomyopathy; SCD = sudden cardiac death; VT = ventricular tachycardia; LV = left ventricle/ventricular; BP = blood pressure).