This session is a debate that will focus on the question of whether there is equipoise regarding the need for a primary prevention ICD in patients with heart failure with reduced ejection fraction (HFrEF) who receive contemporary guideline-directed medical therapy(GDMT) and on the need for further risk stratification strategies in this population prior to recommending a primary prevention ICD. Three trials are currently reassessing the role of primary prevention ICDs, utilizing different risk stratification strategies: the PROFIDEHRA trial, the CONTEMP-ICD trial and the BRITISH trial. This session will review these trials and their potential impact on clinical practice.

• Synthesize the data supporting or not supporting the continued use of primary prevention ICDs in patients with chronic systolic heart failure.
• Describe the role of primary prevention ICDs for preventing sudden cardiac death beyond what can be achieved with guideline-directed medical therapy for heart failure.
• Review the data on risk stratification for sudden cardiac death among patients with chronic systolic heart failure.

James Ip, MD
Sanjeev Saksena, MBBS, MD

Primary Prevention ICDs Should Continue to be Indicated for Patients with HFrEF to Improve Survival
Presenter(s): Sana M. Al-Khatib, MD, MHS

There is Equipoise on the Need to Implant a Primary Prevention ICD in Post-MI Patients with Low LVEF
Presenter(s): Gerhard Hindricks, MD

There is a Need to Use Risk Stratification Strategies Prior to a Decision to Implant a Primary Prevention ICD in Patients with Ischemic or Nonischemic Heart Failure
Presenter(s): Ilan Goldenberg, MD

Sana Al-Khatib:

• Nothing Relevant to Disclose

Gerhard Hindricks:

• Nothing Relevant to Disclose

Ilan Goldenberg:

• Abbott (Research (Contracted Grants for PIs and Named Investigators only) - Research)

To view all Heart Rhythm 2025 Faculty Disclosures, please click here.

Ventricular Tachyarrhythmias
   --   Implantable Cardioverter-defibrillators (ICDs)
      --   225. Know the indications and contraindications for implantation of an ICD for primary prevention of sudden cardiac death in patients with ischemic and nonischemic cardiomyopathy as well as other arrhythmogenic conditions (including channelopathies and other cardiomyopathies) and for secondary prevention of sudden cardiac death.