Hypertrophic cardiomyopathy and sudden cardiac death--ICD indications in the margin of uncertainty

Hypertrophic cardiomyopathy (HCM) represents the most common genetic cardiovascular disease with sudden cardiac death being it's most feared and devastating complication. Due to the availability of an effective prevention method from sudden cardiac death since the development of the implantable cardioverter defibrillator (ICD), identification of high-risk patients has become a prominent objective. For a subgroup of patients clear evidence is lacking and the indication for an ICD is bound to a considerable uncertainty, due to the absence of randomized, prospective trials. In trying to guide and facilitate the decision making process, the following article provides an overview of the current available evidence.