Patent ID: 8560067

Claim:
Apparatus for cardiac therapy, the apparatus comprising: a plurality of electrodes adapted for fixation to a heart chamber; a control unit comprising pulse generating circuitry operable in a plurality of defined pulse output configurations, wherein each pulse output configuration activates a subset of the plurality of the electrodes, the circuitry adapted for outputting: a first pulse type comprising pulses to provide cardiac contractility modulating non-excitatory stimulation pulses to a selected one of the plurality of pulse output configurations in order to stimulate the heart chamber during a refractory period, wherein the pulse generating circuitry is capable of separately generating pulses to one or more of a plurality of electrodes; and a second pulse type comprising a defibrillation signal; and a switching module adapted to switch the control unit between outputting different pulse types, wherein the switching module is responsive to a sensed time delay of a depolarization occurring in at least a portion of the heart.