Is Scar on CMR an Indication for ICD? CMR Guide Leaves Doubts

The CMR GUIDE trial tested whether scar detected by cardiac magnetic resonance (CMR) predicts sudden cardiac death and benefit from an implantable cardioverter defibrillator (ICD) in patients with midrange left ventricular ejection fraction (LVEF 36%-50%). Results showed no overall mortality benefit from ICD despite fewer sudden cardiac deaths, challenging the use of CMR scar as an indication for ICD implantation.

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