In addition, not all patients at high risk of SCD meet ICD indica- tions, such as those with class IV HF without CRT possibility or with a life expectancy <1 year. A meta-analysis of RCTs, which examined the use of amiodarone for the prevention of SCD, included 15 studies with 8522 patients assigned to amio- darone or placebo/control.S7.2.1-12 Amiodarone reduced the risk of SCD by 29%; however, it did not reduce all-cause mortality and was asso- ciated with an increased risk of pulmonary and thyroid toxicity. In a subgroup analysis, the ben- efit of amiodarone appeared similar in patients with ischemic cardiomyopathy and those with In a separate meta-analysis,S7.2.1-13 the evidence was insufficent to support amioda- rone s efficacy for reduction of SCD and all-cause mortality in survivors of cardiac arrest or those with syncope due to VA. A subgroup analysis of the VALIANT (Valsartan in Acute Myocardial Infarction) trial found that amiodarone was asso- ciated with increased mortality in patients with NYHA class III HF.S7.2.1-17 These data call for a care- ful and nuanced approach to using amiodarone for the secondary prevention of SCD in patients with NICM. 7.2.2. Primary Prevention of SCD in Patients With NICM Recommendations for Primary Prevention of SCD in Patients With NICM References that support the recommendations are summarized in Online Data Supplements 27 and 28. 