Patent ID: 8617082

Claim:
A method comprising: obtaining heart sounds from an implanted heart sound sensor; obtaining an electrogram (EGM) from electrodes of an implantable device; generating one or more acoustic cardiographic metrics based on at least one of the heart sounds and the electrogram for a set of cardiac pacing parameters, the set of cardiac pacing parameters including a plurality of pacing parameters; wherein the acoustic cardiographic metrics include one or more of: an indication of atrioventricular (AV) dyssynchrony based on at least an interval from heart sound S 2 to heart sound S 1 ; an indication of interventricular (VV) dyssynchrony based on a splitting of at least one of heart sound S 1 and heart sound S 2 ; an indication of left intraventricular dyssynchrony based on at least one of electromechanical activation delay (EMAT), EMAT plus S 1 duration, heart sound M 1 duration, and heart sound A 2 duration, a surrogate for a myocardial performance index (MPI) based at least on a duration heart sound S 1 and a duration of heart sound S 2 ; an indication of left ventricle (LV) fill time based on the interval between heart sound S 2 and heart sound S 1 ; and an indication of LV contractility based on at least one of: a ratio of EMAT plus heart sound S 1 duration divided by the interval between heart sound S 1 and heart sound S 2 ; the ratio of EMAT plus S 1 duration divided by an R to R interval of the EGM, or an indication of hypertension based on at least one of: heart sound S 1 splitting and heart sound S 2 splitting, relative changes of intensity of M 1 and heart sound T 1 over a predetermined period of time, relative change in a A 2 to heart sound P 2 amplitude ratio over a predetermined period of time, variability in Q wave to heart sound A 2 interval (Q-A 2 ) over time, or heart sound S 4 ; and wherein the acoustic cardiographic metric comprising the indication of VV dyssynchrony is based on the splitting of heart sound S 1 and heart sound S 2 , the method further comprising adjusting one or more cardiac pacing parameters to obtain an S 1 split between M 1 and T 1 that is between approximately 20 and 40 ms and an S 2 split between A 2 and P 2 that is approximately 20 ms.