The value of an electrophysiological study is uncer- tain in asymptomatic arrhythmogenic right ven- tricular cardiomyopathy patients with preserved ventricular function in predicting subsequent risk for SCD. Studies of programmed ventricular stimulation in patients with definite or probable arrhythmogenic right ventricular cardiomyopathy include most symptomatic patients, making rec- ommendations on asymptomatic patients difficult. Electrophysiological studies induce sustained VT in ; many of whom have had prior spontaneous episodes of sustained VT. In patients with primary prevention ICDs, inducible sustained VT did not predict sub- sequent appropriate ICD shocks.S7.3-13 In 1 study including symptomatic patients, patients without inducible VT were less likely to receive appropriate In asymptomatic patients without evidence of VA on ambulatory monitoring, a neg- ative electrophysiological study may have limited value in decision-making for an ICD. CLINICAL STATEMENTS AND GUIDELINES 7.4. Hypertrophic Cardiomyopathy Recommendations for HCM References that support the recommendations are summarized in Online Data Supplement 31. COR LOE Recommendations I B-NR In patients with HCM, SCD risk stratification should be performed at the time of initial evaluation and periodically I B-NR In patients with HCM who have survived an SCA due to VT or VF, or have spontaneous sustained VT causing syncope or hemodynamic compromise, an ICD is recommended if meaningful survival greater than 1 year is expected.S7.4-1,S7.4-6,S7.4-9,S7.4-10 I B-NR In first-degree relatives of patients with HCM, an ECG and echocardiogram should be I B-NR In first-degree relatives of patients with HCM due to a known causative mutation, genetic counseling and mutation-specific genetic testing are IIa B-NR In patients with clinically suspected or diagnosed HCM, genetic counseling and genetic testing IIa B-NR In patients with HCM and 1 or more of the following risk factors, an ICD is reasonable if meaningful survival of greater than 1 year is expected: a. 