The presence of delayed hyperenhancement has been associated with worse outcomes, including 3. It is important to consider genetic etiologies for NICM. Goals of genetic testing for NICM are to identify at-risk relatives who host a disease- causing mutation and to help clarify prognosis. Lamin A/C and NKX 2.5 mutationsS7.2-7 S7.2-12 are associated with a particularly high risk of early conduction disease, arrhythmias, and SCD, and their identification often prompts consideration of early use of an ICD. It is unknown, however, whether early pharmacological treatment of mutation-positive, asymptomatic subjects can prevent or delay manifestation of the disease or whether genetic testing ultimately improves survival. 7.2.1. Secondary Prevention of SCD in Patients With NICM Recommendations for Secondary Prevention of SCD in Patients With NICM References that support the recommendations are summarized in Online Data Supplements 25 and 26. COR LOE Recommendations I B-R In patients with NICM who either survive SCA due to VT/VF or experience hemodynamically unstable VT (LOE: B-R) S7.2.1-1 S7.2.1-4 or stable sustained VT (LOE: B-NR) S7.2.1-5 not due to reversible causes, an ICD is recommended if meaningful survival greater than 1 year is expected. 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. 