A Family History of Sudden Death Should Not Be a Primary Indication for an Implantable Cardioverter Defibrillator in Hypertrophic Cardiomyopathy.

Sudden cardiac death (SCD) is a tragic outcome in hypertrophic cardiomyopathy, but it occurs at a low frequency overall and is challenging to predict accurately. Many important predictors of SCD have emerged over the past 50 years, one of which is a family history of SCD. The available data are limited by their retrospective nature and variability in the definition of family history across studies. We advocate a novel model of risk stratification in which no individual predictor has primacy; rather the overall clinical picture of the patient is used to determine their SCD risk.