Ischemia | Atherosclerosis risk factors (+) | Ischemia/angina at moderate to high intensity exercise levels (> 7METs) | Ischemia/angina at low intensity exercise levels (< 5METs) |
History of CAD but no current ischemia or evidence of atherosclerosis within 1 year | Stable after an ischemic event, coronary artery bypass graft, or angiographic intervention | Complex coronary anatomy not amenable to intervention or revascularization |
Normal EST | Controlled at lower intensity exercises with medications | |
Arrhythmia | Nonsustained, rate-controlled supraventricular arrhythmias with no hemodynamic compromise | Rapid supraventricular arrhythmias with or without symptoms but no hemodynamic compromise | Any arrhythmias with hemodynamic compromise |
Unifocal, infrequent (<10%) premature ventricular contractions | Multifocal premature ventricular contractions, couplets, triplets, or history of nonsustained ventricular tachycardia | Recent history of ventricular tachycardia, ventricular fibrillation, or asystole |
| Patients with pacemakers | Patients with ICDs |
Pump failure | Remote history of CHF controlled with medications | Active CHF controlled with medications | CHF at rest or with mild intensity exercise |
NYHA Class I | NYHA Class II | NYHA Class III or IV |
Mild left ventricular dysfunction (EF > 50%) | Moderate left ventricular dysfunction (EF 40%-50%) | Moderate to severe left ventricular dysfunction (EF < 40%) |
Normal or blunted rise (5-20 mmHg) in systolic blood pressure with moderate-intensity exercise | Blunted or no rise (0-5 mmHg) in systolic blood pressure with mild-to moderate-intensity exercise | Recent history of a fall in systolic blood pressure with or after exercise |