Patent ID: 8761883

Claim:
An implantable medical device comprising: a lead connector connectable to an epicardial left ventricular lead comprising: at least one epicardial electrode provided in connection with a distal end of the epicardial left ventricular lead and electrically connected to a respective electrode terminal provided in connection with an opposite, proximal end of the epicardial left ventricular lead; and a lumen housing a myocardium penetrating catheter with at least one endocardial electrode electrically connected to a respective electrode terminal provided in connection with the opposite, proximal end of the epicardial left ventricular lead; wherein the lead connector comprises multiple connector terminals, each of which is electrically connectable to a respective electrode terminal of the epicardial left ventricular lead; a ventricular pulse generator connected to the lead connector and configured to generate pacing pulses to be applied to the at least one epicardial electrode and to the at least one endocardial electrode; and a pulse generator controller connected to the ventricular pulse generator and configured to control the ventricular pulse generator to i) apply a pacing pulse to one of the at least one epicardial electrode and the at least one endocardial electrode following expiry of an intrinsic time interval from detection of a depolarization at the other of the at least one epicardial electrode and the at least one endocardial electrode if no depolarization is detected at the at least one epicardial electrode and the at least one endocardial electrode following detection of the depolarization but prior to expiry of the intrinsic time interval for a cardiac cycle, and/or ii) apply a pacing pulse to the one of the at least one epicardial electrode and the at least one endocardial electrode following expiry of a paced time interval from application of a pacing pulse at the other of the at least one epicardial electrode and the at least one endocardial electrode if no depolarization is detected at the at least one epicardial electrode and the at least one endocardial electrode following application of the pacing pulse at the other of the at least one epicardial electrode and the at least one endocardial electrode but prior to expiry of the paced time interval for a cardiac cycle.