RCTs of early exercise testing after PCI have excluded patients with recent MI.584 Limited data exist on the safety of early symptom-limited exercise testing after MI; therefore, clinical judgment must be used.585 Pharmacological stress myocardial perfusion imaging has been shown to have predictive value for postinfarction cardiac events and is useful and safe in patients who are unable to exercise.586 The opti- mum timing for provocative testing for ischemia after STEMI remains unresolved. It is argued that a predischarge exercise test may provide psychological benefit to the patient and will permit detection of profound ischemia or other indicators of high risk that could be associated with postdischarge cardiac events that might occur before a symptom-limited stress test scheduled weeks later.585 A predischarge study also provides parameters for exercise prescription in the first few days after return home, before enrollment in cardiac rehabilitation. On the other hand, deferring exercise testing until approximately 3 weeks after STEMI in clinically low-risk patients appears safe and reasonable and enables more optimal assessment of functional capacity. It is the consensus of the writing com- mittee that patients without complications who have not undergone coronary angiography and who might be potential candidates for revascularization should undergo provocative testing before hospital discharge. In patients with noninfarct artery disease who have undergone successful PCI of the infarct artery and have an uncomplicated course, it is reason- able to proceed with discharge and plans for close clinical follow-up with stress imaging within 3 to 6 weeks. 10.2. Assessment of LV Function: Recommendation Class I 1. LVEF should be measured in all patients with STEMI. (Level of Evidence: C) LV function is one of the strongest predictors of survival in patients with STEMI. 