Apparatus and methods for automatic optimization of interventricular and atrio-ventricular delays in real time for cardiac resynchronization in an active implantable medical device
An active implantable medical device for cardiac resynchronization with automatic and almost in real time optimization of the interventricular and atrio-ventricular delays is disclosed. The active implantable medical device includes a closed-loop for continuously controlling the atrio-ventricular delay AVD and the inter-ventricular delay VVD according to a hemodynamic signal delivered by a hemodynamic sensor. The closed-loop provides controlled modulation (38) and demodulation (42) the AVD, and modulation (48) and demodulation (52) the VVD, the modulation and demodulation being functionally interdependent (54, 56) by a sequence of alternating operation. A closed-loop regulator (36) for controlling the AVD receives as input an error signal (EAVD) delivered based on demodulating the AVD (42) and outputs an AVD signal. A closed-loop regulator (46) for controlling the VVD receives as input a signal error (EVVD) based on demodulating the DVV and outputs a VVD signal. In one embodiment, the regulators are PID controllers.
