Monitoring of his bundle pacing capture during ventricular pacing therapy

A system for delivering a cardiac pacing therapy to a patient, comprising:

• a first cardiac lead having a distal end;
• at least one electrode positioned at the distal end of the first cardiac lead to sense a cardiac signal of the patient and deliver a first cardiac pacing therapy;
• a second cardiac lead having a distal end;
• at least one electrode positioned at the distal end of the second cardiac lead to deliver a second cardiac pacing therapy;
• and
• a processor configured to determine an occurrence of one of an intrinsic and a paced atrial depolarization event of a current cardiac cycle in response to the sensed cardiac signal, deliver a first pacing therapy via the at least one electrode of the first cardiac lead during the current cardiac cycle in response to the determined occurrence of the depolarization event, compare an amplitude of the cardiac signal within the current cardiac cycle subsequent to the delivered first pacing therapy to a predetermined amplitude threshold, and determine whether to deliver a second pacing therapy within the current cardiac cycle and subsequent to the delivered first pacing therapy via the at least one electrode of the second cardiac lead in response to the comparing.

A non-transitory computer readable medium storing instructions which cause a cardiac medical device to perform a method comprising:

• sensing a cardiac signal of the patient;
• determining an occurrence of one of an intrinsic and a paced atrial depolarization event of a current cardiac cycle in response to the sensed cardiac signal;
• delivering a first pacing therapy during the current cardiac cycle in response to the determined occurrence of the depolarization event;
• comparing an amplitude of the cardiac signal within the current cardiac cycle subsequent to the delivered first pacing therapy to a predetermined amplitude threshold;
• and
• determining whether to deliver a second pacing therapy within the current cardiac cycle and subsequent to the delivered first pacing therapy in response to the comparing.