A system for monitoring a patient and treating the malfunctioning heart of
the patient, either in an automatic mode or in a semiautomatic mode,
includes means which derive at least one physiologic signal from or
related to the patient's circulatory system representative of hemodynamic
status. A feedback loop is implemented in a biventricular implant, in
order to automatically or selectively optimize the patient's clinical
hemodynamic status. Accordingly, the biventricular implant will be
programmed to go through a series of AV delay, RV-LV timing and heart
rate sequences which scan a preselected range of programmable values and
apply those values to the patient's heart. Hemodynamic patient
measurements will be recorded and preferably graphed over those applied
values. The optimal AV delay, RV-LV timing sequence and pacing rate can
then be selected either manually by a technician, physician or other
operator, or automatically via the implant in order to secure the best
personalized timing sequence for the patient. Preferably, the implant
will also be capable of automatically recording hemodynamic information
and adjusting intervals, in order to optimize hemodynamics without third
party intervention. Also preferably, the automatic adjusting feature can
be selectively programmed on or off using the device programmer, to
control manual or automatic intervention.