Criteria for optimal electrical resynchronization during biventricular pacing

A method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:

• a) pacing using the right ventricular electrode and measuring activation times at a plurality of the left ventricular electrodes;
• b) pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• c) computing a first degree of resynchronization based on a sum of differences of activation times in step a) and corresponding activation times in step b);
• d) pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• e) computing a second degree of resynchronization based on the sum of differences of activation times in step a) and corresponding activation times in step d)
• f) determining the first and second degree of resynchronization are substantially similar;
• and
• g) selecting an optimal LV electrode using a non-degree of resynchronization factor.

A cardiac pacing system employing a right ventricular electrode and a plurality of left ventricular electrodes spatially separated from one another and all coupled to an implantable pulse generator, a processor coupled to the implantable pulse generator, comprising:

• a) the implantable pulse generator delivering pacing stimuli using the right ventricular electrode and measuring activation times at a plurality of the left ventricular electrodes;
• b) the implantable pulse generator delivering pacing stimuli using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• c) the implantable pulse generator delivering pacing stimuli using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• and
• d) the processor employing a sum of differences between the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

A machine readable medium containing executable computer program instructions which when executed by a data processing system cause the system to perform a method of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes, comprising:

• a) pacing using the right ventricular electrode and measuring activation times at a plurality of the left ventricular electrodes;
• b) pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• c) pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes;
• and
• d) employing a sum of differences between the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.