Modifying atrioventricular delay based on activation times

摘要

Methods and/or devices may be configured to monitor ventricular activation times and modify an atrioventricular delay (AV delay) based on the monitored ventricular activation times. Further, the methods and/or devices may determine whether the AV delay should be modified based on the measured activation times before modifying the AV delay.

主权项

1. An implantable medical device operable for delivery of cardiac therapy to a patient, the device comprising:
a therapy delivery module configured to deliver pacing therapy to either the left ventricle or the right ventricle of a patient's heart using at least one electrode; a sensing module configured to sense electrical activity of the patient's heart using at least one other electrode; and a control module coupled to the therapy delivery module and to the sensing module and configured to:
determine an AV delay;control the delivery of the pacing therapy to either the left ventricle or the right ventricle of a patient's heart based on the AV delay, wherein the pacing therapy is delivered over a plurality of heartbeats,sense the electrical activity of the patient's heart using the sensing module during the delivery of the pacing therapy,measure a ventricular activation time for each of the plurality of heartbeats between the delivery of pacing stimulus of the pacing therapy and at least one selected fiducial point of the sensed electrical activity resulting from at least one of the delivered pacing stimulus of the pacing therapy and an intrinsic conduction of the patient's heart, andmodify the AV delay for use in delivering the pacing therapy based on the measured ventricular activation times responsive to determining that one or more of the measured ventricular activation times are greater than or less than a predetermined reference activation time by a selected threshold value,wherein, to modify the AV delay for use in delivering pacing therapy based on the measured ventricular activation times, the control module is further configured to set the AV delay to the last AV delay plus the last measured activation time minus the predetermined reference activation time.