ICDs for Patients With Hypertrophic Cardiomyopathy
The following are key points to remember from this editorial comment on late gadolinium enhancement (LGE) and better selection of patients with hypertrophic cardiomyopathy (HCM) for primary prevention implantable cardioverter-defibrillators (ICDs):

1. Some patients with HCM are at high risk of sudden cardiac death (SCD), and ICD devices can be useful for primary prevention of these events.
2.Clinical variables can identify patients with HCM at increased risk of SCD, and include HCM-related sudden death in relatives, unexplained syncope, massive left ventricular hypertrophy, prolonged nonsustained ventricular tachycardia, attenuated blood pressure with exercise, and high-risk subgroups such as those with left ventricular dysfunction, apical aneurysms, or regional scar.
3.Existing clinical risk scores may miss some patients. Some patients without risk factors experience SCD, and other patients may be difficult to classify. There is a need for improved risk assessment to more accurately identify HCM patients at risk of SCD who may benefit from ICD implantation....

http://www.acc.org/latest-in-cardiology/ten-points-to-remember/2016/12/15/14/37/lge-means-better-selection-of-hcm-pp
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