The indications for ICD therapy 40 days after STEMI are based on LVEF and New York Heart Association class, as derived from the results of the landmark MADIT 2 (Multicenter Automatic Defibrillator Implantation Trial 2) and SCDHeFT (Sudden Cardiac Death in Heart Failure) tri- If LVEF remains 0.35 and the patient has New York Heart Association class II or III HF symptoms, or if the LVEF is 0.30 independent of symptoms, then ICD implanta- tion is recommended.496 Indications for cardiac resynchroniza- tion therapy in the late, convalescent phase of STEMI include residual LV function, NewYork Heart Association class, QRS duration, and LBBB morphology.592 In addition to determination of LVEF, several other non- invasive strategies have been proposed to identify patients at high risk for arrhythmic events after STEMI, such as sig- nal-averaged or high-resolution ECG, heart rate variability, baroreflex sensitivity, and T-wave alternans.591 These strate- gies have not been adopted widely because of their limited O Gara et al 2013 ACCF/AHA STEMI Guideline e399 performance characteristics and are not recommended for routine use. 11. Posthospitalization Plan of Care 11.1. Posthospitalization Plan of Care: Recommendations Class I 1. Posthospital systems of care designed to prevent hos- pital readmissions should be used to facilitate the transition to effective, coordinated outpatient care for all patients with STEMI.593 597 (Level of Evidence: B) 2. Exercise-based cardiac rehabilitation/secondary prevention programs are recommended for patients (Level of Evidence: B) 3. A clear, detailed, and evidence-based plan of care that promotes medication adherence, timely follow- up with the healthcare team, appropriate dietary and physical activities, and compliance with interven- tions for secondary prevention should be provided to patients with STEMI. (Level of Evidence: C) 4. 