Cardiac Rhythm Implantable Devices (CRID) Guidelines

This policy covers implantation and replacement of cardiac rhythm implantable devices (CRIDs) including ICDs, CRT‑D/CRT‑P devices, and permanent pacemakers for prevention and management of life‑threatening arrhythmias and heart‑failure–related conduction disorders. Key covered populations include patients with documented or high‑risk ventricular tachyarrhythmias (primary and secondary prevention), NYHA‑classified heart failure with reduced EF appropriate for CRT, inherited arrhythmia syndromes (e.g., long QT), structural cardiomyopathies (including non‑compaction), and symptomatic bradyarrhythmias. Major limitations require meeting specific CRID indication/non‑indication criteria, documentation of attempts at optimal medical therapy (typically ≥3 months for HF), physician review for atypical presentations, and adherence to payer‑specific coverage rules which may supersede these guidelines.

"Risk factor: Family history of sudden death"