System and method for determining optimal atrioventricular delay based on intrinsic conduction delays

A method for determining an atrioventricular delay value for use in delivering cardiac pacing therapy to a heart of a patient in which an implantable cardiac stimulation device is implanted, the method comprising:

• determining an inter-atrial conduction delay for the patient;
• determining an intrinsic atrioventricular conduction delay for the patient;
• and
• determining an atrioventricular delay value for use in pacing based on the inter-atrial conduction delay and the intrinsic atrioventricular conduction delay;
• wherein determining the atrioventricular delay value based on the inter-atrial conduction delay and the intrinsic atrioventricular conduction delay comprises:
• determining a first candidate delay value (AS-VP1) based on the inter-atrial conduction delay in combination with the intrinsic atrioventricular delay derived from sensed atrial events;
• determining a second candidate delay value (AS-VP2) based on the inter-atrial conduction delay derived from sensed atrial events;
• and
• evaluating a AS-VP delay based on a comparison of AS-VP1 and AS-VP2.

A method for determining an atrioventricular delay value for use in delivering cardiac pacing therapy to a heart of a patient in which an implantable cardiac stimulation device is implanted, the method comprising:

• determining an inter-atrial conduction delay for the patient;
• determining an intrinsic atrioventricular conduction delay for the patient;
• and
• determining an atrioventricular delay value for use in pacing based on the inter-atrial conduction delay and the intrinsic atrioventricular conduction delay;
• wherein determining atrioventricular pacing delay values based on the inter-atrial conduction delay and the intrinsic atrioventricular conduction delay comprises:
• determining a first candidate delay value (AP-VP1) based on the inter-atrial conduction delay in combination with the intrinsic atrioventricular delay derived from paced atrial events;
• determining a second candidate delay value (AP-VP2) based on the inter-atrial conduction delay derived from paced atrial events;
• and
• evaluating a AP-VP delay based on a comparison of AP-VP1 and AP-VP2.

A method for determining an atrioventricular delay value for use in delivering cardiac pacing therapy to a heart of a patient in which an implantable cardiac stimulation device is implanted, the method comprising:

• determining an inter-atrial conduction delay for the patient;
• determining an intrinsic atrioventricular conduction delay for the patient;
• and
• determining an atrioventricular delay value for use in pacing based on the inter-atrial conduction delay and the intrinsic atrioventricular conduction delay;
• wherein determining an inter-atrial conduction delay for the patient comprises detecting the end of at least one atrial event in an atrial intracardiac electrogram (A-IEGM) signal by:
• detecting the onset of the atrial event in the A-IEGM signal;
• opening a detection window within the A-IEGM signal;
• setting positive and negative threshold values;
• identifying a last point in time within the detection window at which the A-IEGM signal falls outside the threshold values;
• and
• identifying the last point in time as being the end of the atrial event.