Patent ID: 8423141

Claim:
A method comprising: detecting a mechanical ventricular event during a cardiac cycle of a heart; determining a timing of the detected mechanical ventricular event during the cardiac cycle; determining a time for delivery of a pre-excitation stimulus to infarct tissue in a ventricle of the heart during a second cardiac cycle based on the timing of the detected mechanical ventricular event; and delivering the pre-excitation stimulus to the infarct tissue at the determined time during the subsequent cardiac cycle; and wherein determining the time for delivery of the pre-excitation stimulus comprises: measuring an A-V m , interval between an atrial event during the cardiac cycle and the mechanical ventricular event during the cardiac cycle; and determining an A-V interval based upon the A-V m interval and wherein delivering the pre-excitation stimulus to the infarct tissue at the determined time comprises: detecting the atrial event during the subsequent cardiac cycle; and delivering the pre-excitation stimulus to the infarct tissue at the A-V interval after the detection; wherein determining the A-V interval based upon the A-V m interval comprises subtracting a re-excitation interval from the A-V m interval; and further comprising: evaluating efficacy of the pre-excitation stimulus; and modifying the pre-excitation interval based on the evaluation; and wherein the measured A-V m interval comprises a first A-V m interval measured in the absence of the pre-excitation stimulation, and evaluating the efficacy of the pre-excitation stimulus comprises: measuring a second A-V m interval during pre-excitation stimulation; and comparing the first and second intervals, and wherein modifying the pre-excitation interval based on the evaluation comprises increasing the pre-excitation interval if the first A-V m interval is less than or equal to the second A-V m interval.