Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract: Feedback is used to control a pulse generator that stimulates electrically excitable tissue. An implanted lead includes stimulation electrode(s) that are spaced from recording electrode(s). The compound action potential received by the recording electrode(s) is processed and integrated over a time window in order to control the amplitude of the pulse generator to maintain more uniform effect from the stimulation.