Implantable electrical nerve stimulator/pacemaker with ischemia detector for decreasing cardiac workload

摘要

A method and apparatus for stimulating the right and/or left carotid sinus nerves or the right stellate ganglion or the epidural space at about T2 with continuous and/or phasic electrical pulses in response to detected myocardial ischemia to decrease cardiac workload as a method to protect the myocardium. The automatic detection of the need for such stimulation is responsive to a change in ST segment variation different from a predetermined or programmed threshold suggesting acute myocardial ischemia and/or other criteria or indicators of myocardial ischemia, including changes if pH and/or oxygen saturation (SO2) detected from a sensor located in the heart, preferably the coronary sinus. The system is implemented with a dual chamber pacemaker with programming and telemetry capabilities for automatically recording in memory the aforementioned values for periods of time preceding and following each instance of stimulation for telemetry out on command and for programming "on" one or more of the sensors.