Abstract: 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 T.sub.2 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 (SO.sub.2) detected from a sensor located in the heart, preferably the coronary sinus.