ST Monitoring to Detect Acute Coronary Syndrome Events in Implantable Cardioverter Defibrillator Patients

This is a prospective, non-randomized, multicenter, pivotal IDE study. The intent of this
study is to demonstrate the safety and effectiveness of the ST Monitoring Feature in the
Fortify® ST, Fortify Assura® ST, and Ellipse® ST family of devices, as well as any future St
Jude Medical devices with the same ST Monitoring Feature capabilities. Effectiveness of the
device will be evaluated by analyzing the sensitivity of the ST Monitoring Feature to detect
clinical events. In addition, safety of the ST Monitoring Feature will be evaluated by
demonstrating a low percentage of patients with false positive events.

Inclusion Criteria:

- Eligible patients will meet all of the following:

1. Have an indication for an ICD implantation or pulse generator change

2. Have documented coronary artery disease. Documented coronary artery disease is
defined as having at least one of the following present a) evidence of a prior MI
on ECG and/or cardiac enzymes, b) prior revascularization (by coronary artery
bypass grafting or percutaneous coronary intervention) c) angina and/or ST-T wave
abnormalities indicative of ischemia on exercise stress test, nuclear stress
test, or echo stress test, or d) coronary artery disease diagnosed by coronary
angiography.

3. Willing and able to comply with protocol requirements, including keeping all
required visits

4. Willing to participate in the study and able to sign an IRB approved informed
consent form

5. Be at least 18 years of age when enrolled in the study

Exclusion Criteria:

- Patients will be excluded if they meet any of the following:

1. Are pacemaker dependent (defined as a need for ventricular pacing ≥ 20% of the
time)

2. Have NYHA Class IV Heart Failure

3. Have persistent or permanent atrial fibrillation

4. Have a known history of intermittent Bundle Branch Block

5. Pregnant or planning a pregnancy during the study participation

6. Have a life expectancy of < 1 year due to any condition

7. Are currently participating in a clinical investigation that includes an active
treatment arm.