Methods and systems of optimizing right ventricular only pacing for patients with respect to an atrial event and left ventricular event

A method of optimizing right ventricular cardiac pacing for a patient, the method comprising:

• distributing electrodes on the patient's torso;
• determining a baseline atrial event time and a baseline left ventricular event time;
• calculating a time interval between the baseline atrial event time and the baseline left ventricular event time;
• selecting a first correction percentage;
• calculating a first atrioventricular delay for right ventricular only cardiac pacing by applying the first correction percentage to the time interval between the baseline atrial event time and the baseline left ventricular event time;
• sensing a first atrial event;
• pacing the patient's right ventricle when a period of time equal to the first atrioventricular delay elapses after sensing the first atrial event;
• and
• receiving first torso-surface potential signals detected by the electrodes.

A system for optimizing right ventricular cardiac pacing for a patient, the system comprising:

• an internal pacing device implanted in the patient's body and configured to:
• determine a first atrial event at a first time and second atrial event at a second time;
• and
• pace the patient's right ventricle after a first atrioventricular pacing delay elapses after sensing the first atrial event, and pace the patient's right ventricle after a second atrioventricular pacing delay elapses that differs from the first right ventricular pacing delay after sensing the second atrial event;
• a set of external electrodes configured to detect first torso-surface potential signals in response to pacing the patient's right ventricle after the first right ventricular pacing delay elapses, and configured to detect second torso-surface potential signals in response to pacing the patient's right ventricle after the second right ventricular pacing delay elapses;
• and
• an external computing device configured to:
• compare the first torso-surface potential signals with the second torso-surface potential signals;
• and
• determine an appropriate correction factor for future right ventricular cardiac pacing for the patient based on the comparison.

A method of determining that a patient should receive right ventricular only cardiac pacing, the method comprising:

• determining a baseline cardiac rhythm, the baseline cardiac rhythm comprising a baseline atrial event time, a baseline left ventricular event time, and a baseline right ventricular event time;
• making a first comparison that comprises comparing the time interval between the baseline atrial event time and the baseline left ventricular event time to the time interval between the atrial event time and the right ventricular event time;
• and
• determining that the patient should receive right ventricular only cardiac pacing based on the first comparison;
• wherein the determination that the patient should receive right ventricular only cardiac pacing is further based on determining that the time interval between the baseline atrial event time and the right ventricular event time is greater than the time interval between the baseline atrial event time and the baseline left ventricular event time;
• making a second comparison that comprises comparing the time interval between the baseline atrial event time and the baseline left ventricular event time to a predetermined threshold, wherein the predetermined threshold is representative of a standard atrioventricular node delay time;
• and
• wherein the determination that the patient should receive right ventricular only cardiac pacing is further based on the second comparison.

A method of optimizing right ventricular cardiac pacing for a patient, the method comprising:

• distributing electrodes on the patient's torso;
• determining a baseline atrial event time and a baseline left ventricular event time;
• calculating a time interval between the baseline atrial event time and the baseline left ventricular event time;
• selecting a first correction percentage;
• calculating a first atrioventricular delay for right ventricular only cardiac pacing by applying the first correction percentage to the time interval between the baseline atrial event time and the baseline left ventricular event time;
• sensing a first atrial event;
• pacing the patient's right ventricle when a period of time equal to the first atrioventricular delay elapses after sensing the first atrial event;
• receiving first torso-surface potential signals detected by the electrodes;
• selecting a second correction percentage that is different than the first correction percentage;
• calculating a second atrioventricular pacing delay for right ventricular only cardiac pacing by applying the second correction percentage to the time interval between the baseline atrial event time and the baseline left ventricular event time;
• sensing a second atrial event;
• pacing the patient's right ventricle when a period of time equal to the second atrioventricular pacing delay elapses after sensing the second atrial event;
• receiving second torso-surface potential signals detected by the electrodes;
• comparing the first torso-surface potential signals with the second torso-surface potential signals, wherein comparing the first torso-surface potential signals with the second torso-surface potential signals comprises comparing a global cardiac electrical heterogeneity represented by the first signals with a global cardiac electrical heterogeneity represented by the second signals;
• and
• selecting the correction percentage for future right ventricular cardiac pacing for the patient based on the comparison, wherein the second correction percentage is selected for future right ventricular only cardiac pacing based on the global cardiac electrical heterogeneity comparison indicating that applying the second correction percentage results in a lower global electrical heterogeneity than applying the first correction percentage.

A system for optimizing right ventricular cardiac pacing for a patient, the system comprising:

• means for determining a first atrial event at a first time and second atrial event at a second time;
• means for pacing the patient's right ventricle after a first atrioventricular pacing delay elapses after sensing the first atrial event, and for pacing the patient's right ventricle after a second atrioventricular pacing delay elapses that differs from the first right ventricular pacing delay after sensing the second atrial event;
• means for detecting a first torso-surface potential signals in response to pacing the patient's right ventricle after the first right ventricular pacing delay elapses, and for detecting a second torso-surface potential signals in response to pacing the patient's right ventricle after the second right ventricular pacing delay elapses;
• and
• means for comparing the first torso-surface potential signals with the second torso-surface potential signals and for determining an appropriate correction factor for future right ventricular cardiac pacing for the patient based on the comparison.