Patent ID: 8527048

Claim:
A method for delivery of pacing therapy to a heart by a patient-internal medical device (PIMD) that includes a pulse generator disposed in a patient-implantable housing that may be provided with a header, the method comprising: sensing, using body-implantable electrodes, at least one local cardiac electrical signal predominantly indicating cardiac electrical activity close to a local site within a heart chamber and at least one non-local cardiac electrical signal comprising a superposition of cardiac electrical signals occurring within the heart and associated with a cardiac contraction, the body-implantable electrodes including a non-local cardiac electrode pair that is used to sense the non-local cardiac electrical signal, the non-local cardiac electrode pair including a first electrode positioned in or on the housing or header and a second electrode positioned in or on the housing or header; sensing for a feature of the local signal corresponding to activation of the heart chamber; sensing for a feature of the non-local signal corresponding to the activation of the heart chamber and including information about activation of a plurality of heart chambers; and timing delivery of one or more pacing pulses based on a temporal relationship between timing of the feature of the local signal and timing of the feature of the non-local signal; wherein the method is carried out on a beat-by-beat basis, such that the sensing for the feature of the local signal, the sensing for the feature of the non-local signal, and the timing delivery of a given one of the one or more pacing pulses are all associated with a given cardiac beat.