Patent ID: 8478406

Claim:
A method of delivering a refractory period stimulation (RPS) therapy, comprising: delivering, during a single cardiac cycle, between one and six successive cardiac refractory period stimulation (RPS) pulses during a refractory period of a cardiac chamber, wherein said delivered RPS pulses occur between a first pair of electrodes, said first pair of electrodes defining a first stimulation vector, wherein said successive pulses are separated by approximately 10 milliseconds (ms) and about 20 ms, wherein each said pulse has a pulse duration of between 0.03 ms and 1.6 ms and wherein each said pulse has a voltage amplitude of between 0.5 volts and 8.0 volts; delivering, during a subsequent cardiac cycle following said single cardiac cycle, a new set of RPS pulses between a second pair of electrodes defining a second stimulation vector; interrupting delivery of the RPS pulses in the event that one of a supra-threshold heart rate is detected and an arrhythmia condition is detected; monitoring a physiologic signal from one of a mechanical cardiac sensor and a metabolic sensor wherein said sensor operatively couples to the cardiac chamber and provides a first output signal correlated to the first stimulation vector and a second output signal correlated to the second stimulation vector; and determining an enhanced RPS therapy delivery vector based at least in part upon a parameter of the first output signal and the second output signal.