Patent ID: 9345887
Filing Date: 2016-05-24
CPC Classification: A61B,A61N

Claim Text:
1. An implantable cardiac rhythm management device, comprising: a plurality of body-implantable electrodes configured to electrically couple to a heart, the plurality of implantable electrodes including at least a first pair of electrodes and a second pair of electrodes, at least one of the first pair of electrodes to be in direct contact with myocardial tissue for use to sense at least one local cardiac signal close to the contacted myocardial tissue such that a sensed local cardiac signal is representative of an activation signal close to the contacted myocardial tissue, the second pair of electrodes to be not in direct contact with myocardial tissue for use to sense non-local cardiac signals such a sensed non-local cardiac signal effectively provides a superposition of a number of activation signals occurring within the heart; sense circuitry coupled to the first and second electrode pairs and configured to sense the at least one local cardiac signal via the at least the first pair of electrodes and the non-local cardiac signal via the second electrode pair; detection circuitry configured to detect a delay interval between an activation of at least one heart chamber and a ventricular intracardiac electrogram peak and to detect a non-local QRS interval; and a control processor configured to: determine a temporal relationship between timing of the local signal feature and timing of the non-local signal feature, wherein the temporal relationship includes a ratio of a time length of the delay interval and a time length of the non-local QRS interval; determine an atrioventricular delay based on the temporal relationship; and time delivery of one or more pacing pulses based on the temporal relationship and the atrioventricular delay.