Patent ID: 8527047

Claim:
An implantable medical device comprising: a tachyarrhythmia detection circuit configured to detect a presence of a tachyarrhythmia in a subject; a sensing circuit, coupled to the tachyarrhythmia detection circuit, and further coupled to a first electrode and a second electrode, wherein the first electrode is configured to be located at a first location in association with a heart of the subject and the second electrode is configured to be located at a second location in association with the heart, and wherein the sensing circuit is configured to sense, in response to and during the tachyarrhythmia, an intrinsic electrical heart depolarization at the first electrode and an intrinsic electrical heart depolarization at the second electrode; a processor circuit, coupled to the sensing circuit and the tachyarrhythmia detection circuit, configured to: determine an intrinsic first time delay between the sensing of the intrinsic electrical heart depolarization at the first electrode and the sensing of the intrinsic electrical heart depolarization at the second electrode; determine a specified second timing delay, the specified second timing delay being at least one of fixed and determined, adjustable over time, within fifty percent of the determined intrinsic first time delay, or shorter than a central tendency of a plurality of measurements of the determined intrinsic first time delay; and an electrostimulation generator circuit, coupled to the processor circuit, configured to: deliver a plurality of electrostimulations using the first electrode; and trigger delivery of each individual electrostimulation in the plurality of electrostimulations, on a beat-by-beat basis, according to the specified second timing delay timed from a respective sensed intrinsic electrical heart depolarization at the second electrode, wherein the delivery of the plurality of electrostimulations is configured to produce an artificial conduction pathway in the heart during tachyarrhythmia; and an anti-tachyarrhythmia therapy circuit, coupled to the processor circuit, configured to provide anti-tachyarrhythmia pacing within a specified number of cardiac cycles after and in response to termination of the delivery of the plurality of electrostimulations and discontinuation of the artificial conduction pathway.