Patent ID: 7194305

Claim:
A method of optimizing the pacing mode and inter-site delay configuration in heart chambers having multiple pacing sites therein using a dual chamber pacemaker of the type having means for sensing atrial depolarization events, means for sensing ventricular depolarization events and means for applying cardiac stimulating pulses selectively to the right, left or both ventricular chambers at a plurality of sites in said right, left or both ventricular chambers at predetermined delay intervals following detection of atrial depolarization events, said method comprising: (a) tracking a patient's intrinsic atrial depolarization events; (b) measuring the patient's atrial cycle length (ACL) between successive atrial depolarization events over a first predetermined number of heart beats, N 1 , establishing a first set of inter-site delay intervals and storing the measured ACLs as an array in a memory to establish a baseline value wherein said inter-site delay intervals involve a plurality of sites in a cardiac chamber and at least one cardiac chamber; (c) changing at least one of one or more inter-site delay intervals and pacing mode configuration s for a second predetermined number of heart beats, N 2 , less than the first predetermined number of heart beats by changing (i) the delay interval of the pacemaker between successive sites from the baseline value to a different delay interval; (d) measuring the patient's ACLs between successive atrial depolarization events over the second predetermined number of heart beats and storing the measuring ACLs in the array in said memory; (e) calculating and storing an ACL feature value obtained from the patient's atrial cycle length measured in (b) and (d); (f) repeating (a)–(e) in iterative cycles over a range of inter-site delay intervals; (g) after (f) for each pacing mode inter-site delay configuration calculating the average of the ACL features over all of the occurrences of the configuration; (h) determining the optimal configuration from among the averages determined in (g); and (i) setting the inter-site delays and pacing mode configuration of the pacemaker to the optimal inter-site delays and pacing mode configuration established in (h).