Patent ID: 7783352

Claim:
An implantable device, comprising: control circuitry configured to control multiple electrodes wherein each electrode of the multiple electrodes is configured for placement at an epicardial position adjacent a left atrium of a heart, an endocardial position adjacent a left atrium of a heart, an intravenous position adjacent a left atrium of a heart, or a position in contact with a pulmonary vein; a cycle detector configured to sense a cycle duration frequency of a repeating reentrant circuit causing atrial fibrillation in the heart based at least in part on electrical signals of the heart sensed via one or more of the multiple electrodes; a timing detector configured to sense a timing at each of the multiple electrodes of a repeating excitable gap of the repeating reentrant circuit; anti-tachycardia pacing (ATP) delivery circuitry configured to apply ATP pulses at one or more of the multiple electrodes, based at least in part on a cycle duration sensed by the cycle detector and timings sensed by the timing detector, to terminate the atrial fibrillation; wherein the ATP delivery circuitry comprises circuitry configured to apply each pulse of the ATP at a different time at each electrode, of the one or more electrodes, according to a frequency associated with the cycle duration of the repeating reentrant circuit wherein the ATP pulse time at each electrode, of the one or more electrodes, is synchronized to coincide with the excitable gap being present at the electrode; and wherein the ATP delivery circuitry comprises circuitry configured to: determine a regularity of the repeating excitable gap sensed at each of the multiple electrodes; rank the multiple electrodes according to the regularity; apply the ATP at one of the multiple electrodes, the one having the highest regularity rank; and if the atrial fibrillation persists, to apply the ATP at each of the other multiple electrodes in turn, according to their regularity rank.