Abstract: An active implantable medical device for cardiac resynchronization includes implantable electrodes configured to detect atrial and ventricular events and to apply electrical pulses to a plurality of stimulation sites of the right and left ventricles, where a first combination of stimulation sites define an original pacing configuration and a second combination of stimulation sites define a changed pacing configuration. A sensing device is configured to measure a peak to peak amplitude of the first peak of endocardial acceleration for each cardiac cycle. A processing circuit is configured to change the pacing configuration from the original pacing configuration to the changed pacing configuration, measure one of a set of values in the changed pacing configuration, and change the pacing configuration from the changed pacing configuration to the original pacing configuration.

Abstract: An implantable prosthetic device for cardiac resynchronization by biventricular pacing including a cardiac reverse remodeling. The combination of the stimulation sites, the atrioventricular delay (AVD), and the interventricular delay (VVD) together define a common pacing configuration, temporarily switched from an original pacing configuration (a) to a modified pacing configuration (b) in a direction opposite to that of an optimization of the hemodynamic parameters, to cause an immediate change in the response to controlled stimulation of the myocardium. This response is assessed based on: the maximum value (P (b, a)) achieved by the peak-to-peak (PEA (i)) of the first peak of endocardial acceleration (PEA) after a pacing configuration change, the mean PEA value (A (b, a)) after stabilization, the PEA variability (V (b, a)) around this average value, and the duration (T (b, a)) of stabilization after the pacing configuration change.

Abstract: Improving cardiac response in terms of pressure, ejected volume, and filling and ejection times by cardiac reverse remodelling, including temporary, occasionally harmful stimulation sequences. An original pacing configuration (a) is switched to a modified pacing configuration (b) in a direction opposite to that of an optimization of the hemodynamic parameters, to cause an immediate change in the response to controlled stimulation of the myocardium. This response is assessed based on: the maximum value (P (b, a)) achieved by the peak-to-peak (PEA (i)) of the first peak of endocardial acceleration (PEA) after a pacing configuration change, the mean PEA value (A (b, a)) after stabilization, the PEA variability (V (b, a)) around this average value, and the duration (T (b, a)) of stabilization after the pacing configuration change.

Abstract: Improving cardiac response in terms of pressure, ejected volume, and filling and ejection times by cardiac reverse remodelling, including temporary, occasionally harmful stimulation sequences. An original pacing configuration (a) is switched to a modified pacing configuration (b) in a direction opposite to that of an optimization of the hemodynamic parameters, to cause an immediate change in the response to controlled stimulation of the myocardium. This response is assessed based on: the maximum value (P (b, a)) achieved by the peak-to-peak (PEA (i)) of the first peak of endocardial acceleration (PEA) after a pacing configuration change, the mean PEA value (A (b, a)) after stabilization, the PEA variability (V (b, a)) around this average value, and the duration (T (b, a)) of stabilization after the pacing configuration change.