B-NR IIa B-NR In patients with NICM who experience syncope presumed to be due to VA and who do not meet indications for a primary prevention ICD, an ICD or an electrophysiological study for risk stratification for SCD can be beneficial if meaningful survival greater than 1 year is IIb B-R In patients with NICM who survive a cardiac arrest, have sustained VT, or have symptomatic VA who are ineligible for an ICD (due to a limited life-expectancy and/ or functional status or lack of access to an ICD), amiodarone may be considered for prevention of SCD.S7.2.1-12,S7.2.1-13 Recommendation-Specific Supportive Text 1. Three prospective RCTs compared the ICD with pharmacological therapy in patients resuscitated from SCA due to VT/VF or hemodynamically sig- The antiarrhythmic medications most commonly used were amio- darone, a beta blocker, or both, although in the CASH (Cardiac Arrest Study Hamburg) trial,S7.2.1-4 there was also a propafenone arm that was termi- nated early due to increased mortality. The 3 tri- als enrolled 1963 patients, but only 292 (14.8%) had NICM. A meta-analysis in which data from AVID and CIDS were pooled found a nonsignifi- cant 31% reduction in all-cause mortality relative to medical therapy in patients with NICM.S7.2.1-3 Although this analysis was underpowered, the observed mortality reduction was consistent with the observed benefit in the entire study popula- tion. In the AVID trial,S7.2.1-1 patients who were ineligible for the RCT were included in a registry, and sustained VT without serious symptoms or hemodynamic compromise was associated with a mortality rate similar to that of patients with unstable VT who were assigned to medical ther- apy. Therefore, stable VT is likely a marker for a substrate capable of producing subsequent lethal CLINICAL STATEMENTS AND GUIDELINES 2. 