Patent ID: 7668594

Claim:
A system for treating a heart with an ischemic region, the system comprising: a sensing circuit to sense one or more physiological signals including one or more ischemia-indicating signals and one or more therapy-monitoring signals; an ischemia detector, coupled to the sensing circuit, to detect an ischemic state indicative of an occurrence of an ischemic event from the one or more ischemia-indicating signals, the ischemic detector including an ischemia locator adapted to locate the ischemic region; a therapy delivery device including a pacing output circuit to deliver a post-ischemia therapy and a chronic pacing therapy each including delivering of pacing pulses; a therapy monitor, coupled to the sensing circuit, to produce one or more therapy-monitoring parameters from the one or more therapy-monitoring signals, the one or more therapy-monitoring parameters each indicative of effectiveness of at least one of the post-ischemia therapy and the chronic pacing therapy; and a controller coupled to the ischemia detector, the therapy delivery device, and the therapy monitor, the controller including: a post-ischemia therapy controller adapted to initiate a delivery of the post-ischemia therapy in response to the occurrence of the ischemic event as indicated by the detected ischemic state and to adjust the delivery of the post-ischemia therapy based on the detected ischemic state, the location of the ischemic region, and at least one post-ischemia therapy-monitoring parameter of the one or more therapy-monitoring parameters, the post-ischemic therapy controller including a post-ischemic pacing controller programmed to adjust one or more regional pacing parameters to provide pre-excitation of the ischemic region to reduce stress and workload of the ischemic region in response to the occurrence of the ischemic event; and a chronic therapy controller adapted to adjust a delivery of the chronic pacing therapy based on the detected ischemic state and at least one chronic therapy-monitoring parameter of the one or more therapy-monitoring parameters, the chronic therapy controller including a chronic pacing controller programmed to adjust one or more global pacing parameters to reduce overall workload on the heart in response to the occurrence of the ischemic event.