An active implantable medical device, in particular a cardiac pacemaker defibrillator and / or cardiovertor type of the type of a ddd / aai has operation optimizes the force

摘要

This device comprises means for collecting the atrial and ventricular events, the means for detecting the presence or absence of a spontaneous conduction atrio - ventricular tachycardia and atrial and ventricular stimulation. It also comprises means such as a sensor of activity to discriminate (12, 42) between the phases of effort and rest, the means for measuring the time of conduction atrio - ventricular between an atrial event, spontaneous or stimulated, of a spontaneous ventricular event following the corresponding means (14 a, 32) of diagnosis of good or bad adaptation of the conduction time to the force, these means operating by evaluating, for the force of the variation of the conduction time as a function of the variation of frequency. It may also be provided with means (40) which, when the diagnosis means indicates a bad adaptation to the force, to deactivate the automatic mode commutation, to tilt the device in the ddd mode and to reprogram the delay atrio - ventricular to a value that is shorter than the value previously programmed.