Patent ID: 8565877

Claim:
A method for selecting a preferred ventricular pacing energy level, for use by an implanted system including an implanted cardiac device and at least one implanted lead, the method comprising: (a) determining a ventricular capture threshold for pacing a ventricle using an implanted lead; (b) determining, using the ventricular capture threshold, a first ventricular pacing energy level that provides for reliable capture of the ventricle; (c) pacing the ventricle at the first ventricular pacing energy level to provoke at least a first ventricular evoked response; (d) determining at least a first ventricular evoked response metric for the at least first ventricular evoked response; (e) pacing the ventricle at a at least second ventricular pacing energy level that is greater than the first ventricular pacing energy level and higher than is necessary for reliable capture of the ventricle to provoke at least a second ventricular evoked response; (f) determining at least a second ventricular evoked response metric for the at least second ventricular evoked response; (g) using the at least first and second ventricular evoked response metrics determined at (d) and (f) to determine whether the at least second ventricular pacing energy level provides a reduction in a patient's estimated level of B-type natriuretic peptide (BNP) compared to the first ventricular pacing energy level, (h) selecting the second ventricular pacing enemy level as the preferred ventricular pacing energy level, when the second ventricular pacing energy level provides a reduction in the patient's estimated level of B-type natriuretic peptide (BNP) compared to the first ventricular pacing enemy level.