**7. Future perspectives**

Currently, familial DCM is likely frequently underdiagnosed, and often genetic testing is not conducted. Increased awareness and availability of genetic evaluation might provide more knowledge and gene-specific therapies and management might become available. Increased identification of affected families will mean that more at-risk individuals will come into contact with health care providers prior to developing the phenotype. This means that future studies should focus on therapies aimed to prevent the development of DCM in these individuals. Further research into the different genotypes and their burden of arrhythmia is also warranted in order to improve risk stratification for sudden cardiac death. This includes the utilization of implantable cardiac monitors in those patients who have certain high-risk genotypes but have been judged not to fulfill criteria for the implantation of an ICD.

#### **8. Conclusion**

Reduced left ventricular systolic ejection fraction is the most common indication for the implantation of an ICD regardless of type of cardiomyopathy. In DCM some

genes have been linked to a propensity for arrhythmia, chief among them LMNA and SCN5A. A mutation in LMNA together with other clinical risk factors could warrant implantation of an ICD.
