The mechanisms underlying SCD in patients with a heart transplant include damage to the conduc- tion system itself and VA due to coronary vas- culopathy or during episodes of acute rejection. Several small case series observing appropriate ICD termination of VA suggest that an ICD can be beneficial in selected patients, particularly those with severe allograft vasculopathy, unex- plained syncope, a history of SCA, and severe LV Additionally, a patient with severe allograft vasculopathy who is being consid- ered for retransplant may be appropriate for an ICD as a bridging device. Secondary prevention indications for an ICD in patients with a heart transplant are identical to those in other patients. 7.8. Neuromuscular Disorders Recommendations for Neuromuscular Disorders References that support the recommendations are summarized in Online Data Supplement 38. COR LOE Recommendations I B-NR In patients with neuromuscular disorders, primary and secondary prevention ICDs are recommended for the same indications as for patients with NICM if meaningful survival of greater than 1 year is expected.S7.8-1,S7.8-2 IIa B-NR In patients with Emery-Dreifuss and limb- girdle type IB muscular dystrophies with progressive cardiac involvement, an ICD is reasonable if meaningful survival of greater than 1 year is expected.S7.8-3 S7.8-8 IIa B-NR In patients with muscular dystrophy, follow- up for development of cardiac involvement is reasonable, even if the patient is asymptomatic at presentation.S7.8-9 S7.8-12 IIb B-NR In patients with myotonic dystrophy type 1 with an indication for a permanent pacemaker, an ICD may be considered to minimize the risk of SCA from VT if meaningful survival of greater than 1 year is expected.S7.8-9,S7.8-13,S7.8-14 Synopsis The muscular dystrophies are a group of inherited diseas- es affecting skeletal and cardiac muscle. 