Patent ID: 8588910

Claim:
An apparatus comprising: a cardiac rhythm management device comprising: an atrial sensing circuit, configured to sense an atrial event; a ventricular pacing circuit configured to deliver biventricular pacing pulses; a ventricular sensing circuit configured to detect an intrinsic ventricular heart beat; a memory comprising instructions; and a processor, coupled to the atrial sensing circuit, the ventricular pacing circuit, the ventricular sensing circuit, and the memory, wherein the instructions, when executed by the processor, cause the processor to: obtain an initial specified atrioventricular (AV) delay; detecting an expiration of the initial specified AV delay; schedule delivery to a heart of a first biventricular pacing pulse to be delivered in response to expiration of the initial specified AV delay; upon detecting an intrinsic ventricular heart beat during the initial specified AV delay, calculate an intrinsic ventricular heart rate interval and obtain a shortened specified AV delay used to deliver subsequent biventricular pacing by adjusting, or adjusting to, a specified non-linear mapping between the initial specified AV delay and the intrinsic ventricular heart rate interval; and detect the expiration of the shortened specified AV delay and schedule delivery of a second biventricular pacing pulse on a next cardiac cycle following the detected intrinsic ventricular heart beat in response to expiration of the shortened specified AV delay; calculate at least one of: a time difference between the intrinsic ventricular heart beat detected during the initial specified AV delay and the scheduled delivery of the first biventricular pacing pulse; and a time difference between an atrial event and the intrinsic ventricular heart beat detected during the initial specified AV delay; wherein the shortened specified AV delay is determined based on at least one of: the time difference between the intrinsic ventricular heart beat detected during the initial specified AV delay and the scheduled delivery of the first biventricular pacing pulse; and the time difference between an atrial event and the intrinsic ventricular heart beat detected during the initial specified AV delay.