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These procedures in modern science are done according to guidelines. So according to ACC (American College of Cardiology) or AHA (American Heart Association) guidelines indications for ICD (implantable cardioverter defibrillator) placement are under two broad categories as follows secondary prophylaxis against sudden cardiac death and primary prophylaxis. For secondary prophylaxis, ICD placement is indicated as initial therapy in survivors of cardiac arrest due to VF (ventricular fibrillation) or hemodynamically unstable VT (ventricular tachycardia). Published guidelines exclude cases in which there are completely reversible causes, primary prophylaxis although this exclusion is somewhat controversial. Currently, indications for primary prophylaxis account for most of ICD implants, even though the evidence for such implants is often less well established. Class I indications that are the benefit greatly outweighs the risk, and the treatment should be administered are as follows: Structural heart disease, sustained VT and syncope of undetermined origin, inducible VT or VF at electrophysiological study (EPS). Left ventricular ejection fraction (LVEF) <35% due to prior MI 9 at least 40 days post-MI (Myocardial infarction) NYHA (New York Heart Association) class II or III, LVEF ≤35%, NYHA class II or III, LVEF ≤30% due to prior MI, at least 40 days post-MI, LVEF < 40% due to prior MI, inducible VT or VF at EPS. So your father's case comes under this. Still there are no ECG showing VT/VF (life threatening arrhythmias), but ICD will prevent those as there are chances for that. When we wait and watch for VT/VF (some people do that) the chance of sudden cardiac death is high. No alternative for ICD. You can still wait and watch if breathing symptoms and EF (ejection fraction) are improving with medicines.