COR LOE Recommendations I B-NR In patients with HCM, SCD risk stratification should be performed at the time of initial evaluation and periodically I B-NR In patients with HCM who have survived an SCA due to VT or VF, or have spontaneous sustained VT causing syncope or hemodynamic compromise, an ICD is recommended if meaningful survival greater than 1 year is expected.S7.4-1,S7.4-6,S7.4-9,S7.4-10 I B-NR In first-degree relatives of patients with HCM, an ECG and echocardiogram should be I B-NR In first-degree relatives of patients with HCM due to a known causative mutation, genetic counseling and mutation-specific genetic testing are IIa B-NR In patients with clinically suspected or diagnosed HCM, genetic counseling and genetic testing IIa B-NR In patients with HCM and 1 or more of the following risk factors, an ICD is reasonable if meaningful survival of greater than 1 year is expected: a. Maximum LV wall thickness 30 mm b. SCD in 1 or more first-degree relatives presumably caused by HCM c. 1 or more episodes of unexplained syncope within the preceding 6 months C-LD C-LD IIa B-NR In patients with HCM who have spontaneous NSVT (LOE: C-LD) S7.4-2,S7.4-26,S7.4-27 or an abnormal blood pressure response with exercise (LOE: B-NR) S7.4-5,S7.4-28,S7.4-29 , who also have additional SCD risk modifiers or high-risk features, an ICD is reasonable if meaningful survival greater than 1 year is expected. 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. 