Background: The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) investigators concluded that in patients with NYHA class II or III congestive heart failure (CHF) and left ventricular ejection fraction (LVEF) of 35 percent or less, primary prevention therapy with implantable cardioverter defibrillator (ICD) reduces overall mortality by 23%. However, it is unclear whether SCD-HeFT criteria for ICD implantation are appropriate for Korean patients. Methods: We analyzed 178 patients who had admitted for decompensated heart failure between January 2004 and December 2005. Fourteen patients met the SCD-HeFT criteria for primary prevention of sudden cardiac death but did not undergo ICD implantation. These patients were selected and followed up for 5 years. Results: The clinical characteristics of 14 patients (64% male, mean age 66 짹 8 years) were summarized in Table 1. The cause of CHF was ischemic in 7 patients and non-ischemic in 7 patients. Three patients died within the follow-up period. Two patients died of sudden cardiac death and one patient died of sepsis. Conclusion: 5-year survival rate was high (0.79) in this study as compared with SCD-HeFT trial (0.64). Further large scale study is needed.