Non-ICD patients were more likely to die while on the transplant list. In a multivariable model, the ICD was not associated with improved survival; however, that analysis was limited by the small sample size.S7.1.2-8 Another small study (n=79) conducted at 1 institution suggested that ICDs reduce the risk of SCD in patients with LVEF 30% who are awaiting heart transplanta- tion; however, this study was limited by the small number of patients.S7.1.2-6 In a retrospective mul- ticenter study of 1089 patients listed for heart transplantation, 550 patients (51%) had an ICD. In 216 patients, the ICD was for primary prevention of SCD and, in 334 patients, the ICD was for sec- ondary prevention. The remaining 539 patients did not receive an ICD. During a median time on the waiting list of 8 months, the ICD was associated with a reduction in all-cause mortality in the pri- mary and secondary prevention cohorts (estimated P=0.0001). This relationship between the ICD and improved survival persisted even after adjusting for potential confounders.S7.1.2-7 6. There are insufficient data from RCTs regard- ing the value of the ICD in patients with NYHA class IV HF. Ambulatory class IV patients with HF were included in the COMPANION (Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure) trial, which showed an overall improved functional status and survival with a Unless such a patient is a candidate for CRT or advanced HF therapies such as heart transplantation or an LVAD, an ICD is not expected to meaningfully prolong survival.S7.1.2-23 7.1.3. Treatment and Prevention of Recurrent VA in Patients With Ischemic Heart Disease Recommendations for Treatment of Recurrent VA in Patients With Ischemic Heart Disease References that support the recommendations are summarized in Online Data Supplements 22 and 23. 