CARDIAC PACING PARAMETER OPTIMIZATION AND MONITORING OF CARDIAC DYSFUNCTION

A plethysmogram signal is sensed from a patient and provided to a programmer device for monitoring the condition of the patient and for optimizing pacing parameters of a cardiac device implanted in the patient. The programmer device analyzes the plethysmogram signal for cardiac performance associated with different pacing parameters. The cardiac performance is indicated by, for example, a pulse amplitude response, a degree of pulsus alternans, or irregularity in the pressure pulses detected in an atrial fibrillation patient. The pacing parameters resulting in the best cardiac performance are selected as the optimum pacing parameters. In one embodiment, the programmer device monitors a Valsalva maneuver performed by a patient. Optimum pacing parameters are derived by analysis of the plethysmogram signals obtained during performance of the Valsalva maneuver while the patient is paced using different pacing parameters.