Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator (ICD) Implantation to Prevent Tachyarrhythmias Following Acute Myocardial Infarction (PROTECT-ICD)

Inclusion Criteria: * 2-40 days (inclusive) following a myocardial infarct * Impaired left ventricular systolic function (LVEF≤40% or at least moderately impaired) Exclusion Criteria: 1. Age \<18 or \>85; 2. Pregnancy; 3. Nursing home resident dependent on one or more activities of daily living; 4. Significant non-cardiac co-morbidity with high likelihood of death within 1 year (this would include any metastatic malignancy, or other terminal disease); 5. Significant psychiatric illnesses that may be aggravated by device implantation or that may preclude regular follow up; 6. Intravenous drug abuse (ongoing); 7. Unresolved infection associated with risk for hematogenous seeding; 8. Pre-existing implantable cardioverter-defibrillator (ICD); 9. Secondary prevention indication for an ICD (i.e. sustained ventricular arrhythmias occurring more than 48 hours after qualifying myocardial infarction (patients with ventricular arrhythmias occurring ≤48 hours of myocardial infarction, or with non-sustained ventricular tachycardia at any time, are not excluded)); 10. On the heart transplant list; 11. Recurrent unstable angina despite revascularisation (defined as ongoing chest pain or ischemic symptoms at rest or with minimal exertion despite adequate treatment with anti-anginal medications);\*\* 12. Congestive heart failure New York Heart Association class IV, defined as shortness of breath at rest, which is refractory to medical treatment (not responding to treatment)\*\* \*\*NOTE: patients who meet exclusion based on (11) or (12) can be reviewed again in 2-3 days and if symptoms have resolved or treatment performed can be re-considered for inclusion.