Automated optimization of his bundle pacing for cardiac resynchronization therapy

A cardiac stimulation system adapted to provide cardiac resynchronization therapy (CRT) for a patient heart, the stimulation system comprising:

• a pulse generator;
• a stimulating electrode coupled to the pulse generator and configured to be disposed in proximity to a His bundle of the patient heart;
• a sensing electrode coupled to the pulse generator and adapted to sense electrical activity of a left ventricle (LV) of the patient heart;
• a processor communicatively coupled to the pulse generator;
• and
• a memory communicatively coupled to the processor, the memory including instructions executable by the processor that, when executed by the processor, cause the processor to:
• apply, using the pulse generator and through the stimulating electrode, a His bundle pacing (HBP) impulse having a first impulse energy;
• measure, using the sensing electrode, an LV activation time in response to the HBP impulse;
• and
• modify, based on the LV activation time, at least one setting of the pulse generator stored in the at least one memory such that a subsequent HBP impulse to be provided by the pulse generator via the stimulating electrode has a second impulse energy different from the first impulse energy.