Information should be provided about the efficacy, safety, and potential complications of an ICD and the potential for defibrillation to be inactivated if desired in the future, notably when a patient is approaching end of life. This will facilitate shared decision making between patients, families, and the medical care team about ICDs (31). AF indicates atrial fibrillation; AV, atrioventricular; COR, Class of Recommendation; CRT, cardiac resynchronization therapy; GDMT, guideline-directed medical therapy; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; ICD, implantable cardioverter-defibrillator; LBBB, left bundle-branch block; LOE, Level of Evidence; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NYHA, New York Heart Association; and SCD, sudden cardiac death. JACC Vol. 62, No. 16, 2013 Yancy et al. October 15, 2013:1495 539 2013 ACCF/AHA Heart Failure Guidelines: Executive Summary Figure 2. Indications for CRT therapy algorithm. CRT indicates cardiac resynchronization therapy; CRT-D, cardiac resynchronization therapy-de brillator; GDMT, guideline-directed medical therapy; HF, heart failure; ICD, implantable cardioverter-de brillator; LBBB, left bundle-branch block; LVEF, left ventricular ejection fraction; MI, myocardial infarction; and NYHA, New York Heart Association. Table 18. ESC Definition of Advanced HF 1. Severe symptoms of HF with dyspnea and/or fatigue at rest or with minimal exertion (NYHA class III or IV) 2. Episodes of fluid retention (pulmonary and/or systemic congestion, peripheral edema) and/or reduced cardiac output at rest (peripheral hypoperfusion) 3. Objective evidence of severe cardiac dysfunction shown by at least 1 of the following: a. LVEF <30% b. Pseudonormal or restrictive mitral inflow pattern c. Mean PCWP >16 mm Hg and/or RAP >12 mm Hg by PA catheterization d. High BNP or NT-proBNP plasma levels in the absence of noncardiac causes 4. Severe impairment of functional capacity shown by 1 of the following: a. Inability to exercise b. 6-Minute walk distance 300 m c. Peak _ 5. 