Method and apparatus for evaluating and optimizing ventricular synchronization

A computer readable medium for performing a method of improving cardiac resynchronization therapy based upon detected physiologic characteristics of a heart, comprising:

• instructions for measuring a pressure development characteristic of a first ventricle and a second ventricle and based on individual measurements of pressure development for said first ventricle and for said second ventricle during at least one cardiac cycle;
• instructions for determining whether the first ventricle or the second ventricle relatively leads pressure development and proceeding to the next step if the determination is affirmative or halting the method if the determination is negative;
• and
• instructions for adjusting a timing parameter of a first pacing electrode in electrical communication with the first ventricle relative to a second pacing electrode in electrical communication with the second ventricle so that pressure development in the first ventricle and the second ventricle occurs substantially at the same time.

A method for optimizing ventricular synchronization comprising:

• measuring a right ventricular pressure and a left ventricular pressure during at least one cardiac cycle;
• determining a metric of ventricular synchronization based on the relationship between the measured right ventricular pressure and the measured left ventricular pressure so that said metric compensates for the ventricle leading in pressure development during ventricular asynchrony;
• comparing the metric to a predetermined criterion that distinguishes acceptable ventricular synchrony from unacceptable ventricular asynchrony;
• and
• adjusting a therapy when the metric does not meet the criterion for acceptable ventricular synchrony.

A closed loop method of improving cardiac resynchronization therapy based upon detected physiologic characteristics of a heart, comprising:

• means for measuring a pressure development characteristic of a first ventricle and a second ventricle and based on individual measurements of pressure development for said first ventricle and for said second ventricle during at least one cardiac cycle;
• means for determining whether the first ventricle or the second ventricle relatively leads pressure development and proceeding to the next step if the determination is affirmative or halting the method if the determination is negative;
• and
• means for adjusting a timing parameter of a first pacing electrode in electrical communication with the first ventricle relative to a second pacing electrode in electrical communication with the second ventricle so that pressure development in the first ventricle and the second ventricle occurs substantially at the same time.