Patent ID: 8571655

Claim:
An implantable device for delivering cardiac function therapy to a patient, comprising: pulse generation circuitry for delivering pacing pulses to multiple ventricular sites and for delivering stimulation pulses to parasympathetic nerves innervating the heart; a controller configured for controlling the delivery of pacing pulses to the multiple ventricular sites and the delivery of the parasympathetic stimulation; a sensor configured for measuring cardiac output; an exertion level sensor configured for measuring the patient's exertion level; wherein the controller is programmed to deliver the multi-site ventricular pacing therapy while the parasympathetic stimulation is being delivered and wherein the controller is further programmed to deliver the multi-site ventricular pacing therapy with a pacing pulse output sequence that pre-excites at least one myocardial region relative to other regions for reducing ventricular wall stress; and, wherein the controller is further programmed to deliver the multi-site ventricular pacing in a manner that enforces a minimum ventricular rate; wherein the controller is programmed to compute a function that maps exertion levels to minimum cardiac output values considered to be adequate for a particular exertion level and is further programmed to cease the delivery of parasympathetic stimulation if the current measurement of the exertion level maps to a minimum cardiac output value that is greater than the current measurement of cardiac output.