Atrial nerve stimulation with ventricular pacing

A method for stimulating a patient's heart, comprising:

• delivering an atrial pacing pulse to an atrial chamber to generate an evoked atrial depolarization;
• delivering a stimulation pulse to an atrioventricular node to increase a PR interval of the heart by delivering the stimulation pulse during a stimulation window having a start time corresponding to the delivered atrial pacing pulse so that the stimulation pulse is delivered during a refractory period corresponding to the evoked atrial depolarization;
• and
• delivering a ventricular pacing pulse to a first ventricular chamber during the increased PR interval to cause a contraction of the first ventricular chamber to occur prior to a contraction of a second ventricular chamber to increase dyssynchrony between the contraction of the first ventricular chamber and the contraction of the second ventricular chamber.

A non-transitory computer readable medium having computer executable instructions for performing a method for stimulating a patient's heart, comprising:

• delivering an atrial pacing pulse to an atrial chamber to generate an evoked atrial depolarization;
• delivering a stimulation pulse to an atrioventricular node to increase a PR interval of the heart by delivering the stimulation pulse during a stimulation window having a start time corresponding to the delivered atrial pacing pulse so that the stimulation pulse is delivered during a refractory period corresponding to the evoked atrial depolarization;
• and
• delivering a ventricular pacing pulse to a first ventricular chamber during the increased PR interval to cause a contraction of the first ventricular chamber to occur prior to a contraction of a second ventricular chamber to increase dyssynchrony between the contraction of the first ventricular chamber and the contraction of the second ventricular chamber.

A medical device for stimulating a patient's heart, comprising:

• a plurality of electrodes;
• pacing circuitry coupled to the plurality of electrodes to deliver, via the plurality of electrodes, an atrial pacing pulse to an atrial chamber to generate an evoked atrial depolarization and to deliver stimulation to an atrioventricular node of the heart;
• and
• a processor coupled to the pacing circuitry, the processor configured to deliver the stimulation to the atrioventricular node to increase a PR interval of the heart, the stimulation delivered during a stimulation window and comprising a train of at least two pulses that cause prolonged conduction of the evoked atrial depolarization to a ventricular chamber, and to deliver a ventricular pacing pulse to a first ventricular chamber during the increased PR interval to cause a contraction of the first ventricular chamber to occur prior to a contraction of a second ventricular chamber to increase dyssynchrony between the contraction of the first ventricular chamber and the contraction of the second ventricular chamber.