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Algorithm for assessment of need for implantation of a cardioverter/defibrillator. The appropriate management is selected based upon measurement of left
ventricular ejection fraction and assessment of the NYHA functional class. Patients with depressed left ventricular function at least 40 days post-STEMI are
referred for insertion of an implantable cardioverter/defibrillator (ICD) if the LVEF is <30–40% and they are in NYHA class II–III or if the LVEF is <30–35%
and they are in NYHA class I functional status. Patients with preserved left ventricular function (LVEF >40%) do not receive an ICD regardless of NYHA
functional class. All patients are treated with medical therapy post-STEMI. [Adapted from data contained in Zipes DP, et al: ACC/AHA/ESC 2006
guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death; a report of the American College of
Source: Chapter 245. ST-Segment Elevation Myocardial Infarction, Harrison's Principles of Internal Medicine, 18e
Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to
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