Active implantable medical device, in particular a heart pacemaker, defibrillator, and / or cardioverter or more places device, with impact - to - impact capture test

摘要

This device comprises a stage of stimulation with: an output capacitor (12); a circuit (14) for charging the capacitor to a voltage (v1) of stimulation, close to the threshold of efficacy of stimulation of the patient; the first switching means (18), adapted to connect the capacitor to a terminal of a stimulation (16) of the device; the test means, adapted to determine, after delivery of a stimulation, if that - latter has been effective, or if, on the contrary, there is a loss of capture; means for readjustment of the stimulation voltage as a function of the result of the capture test; and means for delivery of a stimulation against - after the test of capture, if the result of this test reveals a loss of capture. The means of delivery of a stimulation against - includes means of additional capacitors (32), and the second switching means (34), adapted to connect these means additional capacitors to said terminal of the stimulation of the device (16).