Patent ID: 6882883

Claim:
An implantable medical device (IMD) for implantation in a patient to detect symptomatic and asymptomatic myocardial ischemia, comprising: pacing circuitry configured to selectively produce pacing pulses at a programmable pacing rate for delivery to muscle tissue of a heart of the patient, wherein the pacing circuitry is configurable to subject the patient to a variety of stress tests, and wherein the variety of stress tests further comprise: (i) a first stress test protocol wherein the programmable pacing rate is slowly increased at from between about five paces per minute (ppm) to about ten ppm from a start rate to a stop rate, wherein the stop rate is greater than the start rate, and the patient's response to the first stress test protocol is acquired and stored in a memory structure as a part of a stress test data set; (ii) a second stress test protocol wherein the IMD is configurable to store timing information specifying a time the IMD is to subject the patient to the first stress test protocol, and to subject the patient to the first stress test protocol at the time, day and/or date specified by the timing information, and the patient's response to the second stress test protocol is acquired and stored in the memory structure as a part of the stress test data set; and (iii) a third stress test protocol wherein the protocol comprises recreating the physiologic conditions of a previously stored episode of paced or intrinsic symptomatic myocardial ischemia that were stored in the memory structure after the patient triggers an episode storage event, and the patient's response to the third stress test protocol is acquired and stored in the memory structure as a part of the stress test data set.