C-LD IIb B-NR In patients with HCM who have NSVT or an abnormal blood pressure response with exercise (LOE: but do not have any other SCD risk modifiers, an ICD may be considered, but its benefit is uncertain. B-NR IIb C-LD In patients with HCM and a history of sustained VT or VF, amiodarone may be considered when an ICD is not feasible or not preferred by the patient.S7.4-30,S7.4-31 III: No Benefit B-NR In patients with HCM, an invasive electrophysiological study with programmed ventricular stimulation should not be performed for risk stratification.S7.4-32,S7.4-33 III: No Benefit B-NR In patients with an identified HCM genotype in the absence of SCD risk factors, an ICD should not be implanted.S7.4-7,S7.4-34,S7.4-35 Refer to the ACCF/AHA HCM guideline for the defi- nition of HCM.S7.4-36 Recommendation-Specific Supportive Text 1. Patients with HCM have approximately a 1% risk of SCD per year.S7.4-1,S7.4-6 Selection of patients who are appropriate candidates for implanta- tion of an ICD can be a difficult clinical decision because of the individuality of each patient and family, variable definitions of risk factors and risk modifiers, sparse clinical data, the relative infre- quency of both HCM and SCD in most clinical practices, and the potential complications of liv- ing with an ICD. Table 8 lists risk factors and risk modifiers associated with SCD in patients with HCM. ICD risk stratification should be performed every 1 to 3 years in patients with HCM. There is increasing evidence supporting the association of late gadolinium enhancement on cardiac MRI with the risk of sudden death and it is included as a risk modifier.S7.4-37 S7.4-39 LV aneurysm may be Table 8. 