Closed loop optimization of control parameters during cardiac pacing

A medical device system for optimizing a pacing control parameter, comprising:

• a plurality of cardiac electrodes;
• a cardiac signal generator coupled to the electrodes for delivering cardiac pacing pulses;
• a sensing module coupled to the cardiac electrodes for acquiring an EGM signal;
• and
• a processor configured to determine a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart and adjust a pacing therapy control parameter to maintain the EGM-based index value corresponding to the optimal electrical activation condition during delivery of the cardiac pacing pulses.

A non-transitory, computer-readable storage medium comprising instructions that, when executed, cause a processor included in a medical device system to:

• determine a value of an EGM-based index corresponding an optimal electrical activation condition of a patient's heart;
• control a signal generator to deliver a pacing therapy to the heart;
• and
• adjust a pacing therapy control parameter to maintain the EGM-based index value corresponding to the optimal electrical activation condition.