An intra-aortic balloon pump (IABP) having improved automated electrocardiogram (ECG) based intra-aortic balloon deflation timing. Said IABP capable of automatically determining to either deflate the intra-aortic balloon upon the detection of the next cardiac cycle (non-predictive deflation) or at an earlier point derived from predicting the occurrence of the next cycle (predictive deflation). This automated determination is based upon a quantitative assessment of the performance of the intra-aortic balloon pump in predicting the prevailing cardiac rhythm. The accuracy of deflation based upon beat-to-beat interval prediction is scored relative to actual beat-to-beat interval. Once the cumulative prediction score of a predetermined number of historic beat-to-beat intervals reaches a predetermined threshold for non-predictive deflation, the non-predictive deflation mode is automatically activated. Scoring of beat predictions continues in this mode to signal when to switch back to predictive deflation.
