The active implantable medical device, in particular a cardiac pacemaker cardiovecteur or multisite device, comprising means for adjusting the cycle to cycle of the amplitude of the stimulation

摘要

The device comprises means of a ventricular stimulation, the means for adjusting the amplitude of the stimulation, the means for periodically evaluating a threshold and define an amplitude of safety (vs), and means for determining the detection or loss of capture on a cardiac cycle following stimulation with an amplitude of the stimulation (v) is given. It is also provided with means for defining an amplitude of capture (vc) greater than or equal to the threshold for driving, but less than the amplitude of safety. The adjustment means are able to temporarily reduce the amplitude of the stimulation to the - bottom of the amplitude of security to the amplitude value of capture (vc), check, immediately after the stimulus to this amplitude is reduced, the detection or loss of capture (stages 12, 14); in the event of detection, to the next cardiac cycles, the amplitude of a stimulation to the value of the amplitude of capture (step 16); and, in the event of loss of capture, define a new value, greater than the current value of the amplitude of capture (steps 44, 46).