Patent ID: 7548782

Claim:
A method, comprising: identifying a stressed region of a patient's myocardium; implanting a pacing device with one or more electrodes including a pacing electrode disposed at a first pacing site in proximity to the stressed region; programming the pacing device to deliver pacing therapy to the first pacing site in a manner such that the stressed region of the myocardium is excited before other regions of the myocardium in order to subject the stressed region to less mechanical stress when the myocardium contracts; programming the pacing device to measure the patient's exertion level with an accelerometer or minute ventilation sensor; and, programming the pacing device to alternate between a pulse output sequence that pre-excites the stressed region and a pulse output sequence that does not in accordance with the exertion level measurement such that pre-excitation of the stressed region is discontinued during periods of increased exertion.