An apparatus and method for treating post-
defibrillation electromechanical dissociation ("EMD"). A first embodiment comprises an implantable defibrillator, which may include
cardioversion and pacemaker capabilities, which has the capability of detecting and treating post
defibrillation EMD. The stimulator / defibrillator has one or more leads with electrodes. At least one
electrode for
defibrillation may be an endocardial or epicardial
electrode or other suitable defibrillation
electrode. A sense circuit senses the electrical condition of the heart of the patient. A hemodynamic sensor senses a parameter correlated to the state of
blood flow. The cardiac stimulator / defibrillator detects
ventricular tachyarrhythmia including
fibrillation and terminates
ventricular tachyarrhythmia. After termination of the
ventricular tachyarrhythmia, the stimulator / defibrillator can detect the presence of electrical
rhythm in the heart correlated, however, with inadequate
blood flow to sustain life. Under such conditions, the device provides an output to stimulate the heart to overcome electromechanical dissociation and restore adequate
blood flow. The device may also be an external therapy device, as part of, or in conjunction with an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or
ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a
fibrillation and providing electrical therapy, the therapy comprising a series of packets of electrical pulses.