(pnoninferiority < 0.0001) SIMPLE Trial design: Patients receiving an ICD implantation were randomized to routine defibrillation threshold (DFT) testing or no testing. They were followed for 3.1 years. Results (pnoninferiority < 0.0001) (psuperiority = 0.30) Primary outcome: Failed appropriate shock or arrhythmic death for no testing vs. routine DFT testing: 7.2% vs. 8.3%; pnoninferiority < 0.0001 Post-procedure: Chest compressions: 0% vs. 0.4%, p = 0.06; intubation: 0.1% vs. 0.6%, p = 0.03 CHF admission: 11.2% vs. 10.7%, p = 0.72 % Conclusions No DFT testing was noninferior to routine DFT testing at the time of ICD implantation for sub-sequent failed appropriate shocks/arrhythmic death Important finding; has the potential to simplify ICD implantation and lower costs Primary endpoint No DFT testing (n = 1,247) Routine DFT testing (n = 1,253) Healey JS, et al. Lancet 2015;Feb 22:[Epub]