Patent ID: 9403012
Filing Date: 2016-08-02
CPC Classification: A61N

Claim Text:
1. An active implantable medical device of neurostimulation by controlled simultaneous application of electrical pulses in several points of a body, comprising: a control device with a generator of electrical pulses; a neurostimulation lead adapted to be placed around, near or within the body, and having a plurality of electrodes individually connected to the control device; and a sensing electrode for measuring a physiological parameter representative of the patient's cardiac activity, the physiological parameter being one of an electrocardiogram signal, a pressure signal in the left ventricle of the heart, and an endocardial acceleration signal, the control device having a distributor circuit associated with the control device and capable of varying the stimulation configuration to preferentially stimulate certain parts of the body with respect to other regions, said stimulation configuration comprising the selection of the active electrodes connected to the pulse generator, the anode or cathode polarity of these active electrodes, as well as the optional division of the respective currents delivered to these active electrodes, wherein the control device further comprises circuitry configured for iterative determination of an optimum stimulation configuration, wherein the iterative determination comprises: wherein the control device further comprises circuitry for detecting adverse effects that might be generated by neurostimulation, wherein storing the measured physiological parameter for each selected stimulation configuration comprises storing for each selected stimulation configuration an indicator of the possible occurrence of an adverse effect; and wherein the optimum configuration is also designated according to the stored values of the indicator of possible occurrence of an adverse effect and the number of active electrodes used as cathodes with each selected pacing configuration.