A system and method for estimating optimal atrioventricular delay values
for use in pacing the ventricles. Both the intrinsic inter-atrial
conduction delay and the intrinsic atrioventricular conduction delay are
determined for the patient and then the preferred atrioventricular pacing
delay is derived therefrom. By taking into account intrinsic inter-atrial
delay along with intrinsic atrioventricular delay, a more reliable
estimate of the true optimal atrioventricular delay values for the
patient can be achieved than with techniques that only take into account
intrinsic atrioventricular delay values. In one example, the technique
uses intracardiac electrogram (IEGM) signals and surface
electrocardiogram (EKG) signals and hence can be performed by an external
programmer without requiring Doppler echocardiography or other cardiac
performance monitoring techniques. In another example, wherein the
implanted device is equipped with a coronary sinus lead, the technique
uses only IEGM signals and hence can be performed by the device itself.