Patent ID: 7711420

Claim:
A cardiac device, comprising: one or more pacing channels for delivering pacing pulses to one or more myocardial sites; a controller programmed to operate the device in either a normal operating mode or to deliver cardioprotective pacing in a cardioprotective mode; wherein, in the cardioprotective mode, the controller is programmed to deliver paces to the one or more myocardial sites using a pacing mode that results in some degree of ventricular dyssynchrony as compared with the normal operating mode; wherein the controller is programmed to periodically or intermittently switch from the normal operating mode to the cardioprotective mode according to exit and entry conditions; a plurality of sensors for sensing physiological variables reflective of either the degree of ventricular dyssynchrony or a patient's physiological response to the ventricular dyssynchrony produced by the cardioprotective pacing; wherein the controller is programmed to compute a stress index as a function of one or more of the sensed physiological variables; wherein the controller is programmed to compute a protective index as a function of one or more of the sensed physiological variables; wherein the controller is programmed to modify one or more cardioprotection parameters that affect the amount of ventricular dyssynchrony produced by the cardioprotective pacing in a manner that tends to maintain the protective index at a specified desired protection level value; and, wherein the controller is programmed to compare the computed stress index with a specified stress limit range and to adjust the desired protection level value to decrease the amount of ventricular dyssynchrony produced by the cardioprotective pacing if the stress index is in the specified stress limit range.