Painless ventricular rate control during supraventricular tachycardia

In response to detecting a supra ventricular tachycardia (SVT) in a patient, a method for painless treatment of the SVT comprising:

• delivering the following between consecutive sensed intrinsic ventricular activations
• a pacing pulse to a ventricle during a refractory period;
• and
• a burst of stimulation to one or more cardiac fat pad that innervates at least one of atrioventricular (AV) node tissue and ventricular tissue, wherein an amplitude of the burst of stimulation is a programmed cardiac fat pad stimulation amplitude that is lower than a level at which the patient will feel pain.

An implantable system adapted to painlessly reduce ventricular rate during a supra ventricular tachycardia (SVT), comprising:

• memory to store a cardiac fat pad stimulation amplitude that is lower than a level at which the patient will feel pain;
• a monitor to monitor for SVT;
• one or more pulse generator;
• at least one pacing electrode to deliver pacing pulses to a ventricle;
• and
• at least one stimulation electrode to deliver stimulation to one or more cardiac fat pad that innervates at least one of atrioventricular (AV) node tissue and ventricular tissue;
• where, in response to the monitor detecting a SVT, the one or more pulse generator
• generates and delivers, via at least one said pacing electrode, a pacing pulse to a ventricle during a refractory period following an intrinsic ventricular activation, to thereby extend the refractory period;
• and
• generates and delivers, via at least one said stimulation electrode, prior to the next intrinsic ventricular activation, a burst of stimulation to one or more cardiac fat pad that innervates at least one of AV node tissue and ventricular tissue, to slow AV node conduction, wherein an amplitude of the burst of stimulation is the programmed cardiac fat pad stimulation amplitude that is lower than the level at which the patient will feel pain.