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Identifying adults with congenital heart disease (CHD) at high risk for sudden death who stand to benefit from primary prevention implantable cardioverter-defibrillators (ICDs) remains a major challenge. Inconsistencies among evidence-based recommendations by various professional societies can be a source of confusion to practicing clinicians. This article summarizes and compares recommendations from the Canadian Cardiovascular Society management guidelines on adults with CHD (2009), expert consensus from the Pediatric and Congenital El