Patent ID: 8483826

Claim:
An apparatus comprising: at least one implantable cardiac depolarization sensing circuit configured to provide a sensed depolarization signal from a ventricle; an electrical stimulation circuit configured to provide pacing electrical stimulation energy to at least one implantable electrode in the ventricle; and a pacing mode controller communicatively coupled to the cardiac depolarization sensing circuit and the electrical stimulation circuit, wherein the pacing mode controller is configured to: deliver pacing therapy according to a first pacing mode, wherein the first pacing mode is included in a normal operating mode; deliver pacing therapy according to a second pacing mode, wherein the second pacing mode senses intrinsic cardiac events differently than in the first pacing mode, triggers or inhibits delivery of pacing pulses according to intrinsic cardiac events differently than in the first pacing mode, and increases mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode; deliver pacing therapy according to a third pacing mode different from the second pacing mode, wherein the third pacing mode senses intrinsic cardiac events differently than in the first pacing mode, triggers or inhibits delivery of pacing pulses according to intrinsic cardiac events differently than in the first pacing mode or the second pacing mode, and increases mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode; alternate between the second and third pacing modes when pacing is changed from the normal operating mode to a stress augmentation mode; and suspend a change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.