Colors correspond to Class of Recommendation in Table 1. See Section 7.1.2 for discussion. *Scenarios exist for early ICD placement in select circumstances such as patients with a pacing indication or syncope Advanced HF therapy includes CRT, cardiac transplant, and LVAD thought due to VT. These are detailed elsewhere in an HRS/ACC/AHA expert consensus statement.S7.1.2-24 CRT indicates cardiac resynchronization therapy; EP, electrophysiological; GDMT, guideline-directed management and therapy; HF, heart failure; ICD, implantable cardioverter-defibrillator; IHD, ischemic heart disease; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NSVT, nonsustained ventricular tachycardia; NYHA, New York Heart Association; pts, patients; SCD, sudden cardiac death; VT, ventricular tachycardia; and WCD, wearable cardioverter-defibrillator. Recommendations for Primary Prevention of SCD in Patients With Ischemic Heart Disease (Continued) COR LOE Recommendations CLINICAL STATEMENTS AND GUIDELINES contrast, when survival was not increased by ICD implantation, as in the CABG-Patch trial,S7.1.2-18 the ICD did not provide value, because the higher costs were unaccompanied by a gain in life expectancy. 4. MUSTT (Multicenter Unsustained Tachycardia Trial) demonstrated that patients with prior MI, NSVT, and reduced LVEF with inducible VT at elec- trophysiological study have a higher overall mor- tality rate than similar patients without inducible Patients who received an ICD after failing to have inducible VT suppressed by an antiarrhythmic medication had lower mortal- ity rate than those who did not receive an ICD. Although the entry criteria into MUSTT required an LVEF of 40%, the average LVEF in enrolled patients was 30%, and ICD placement was not randomized but rather was selected by the treat- ing physician for patients with VT that could not be suppressed with antiarrhythmic medication therapy. MUSTT allowed enrollment of patients who were 4 days after an acute MI or revascu- larization. 