Patent ID: 8219193

Claim:
An active implantable medical device for cardiac resynchronization therapy, comprising: means for detecting spontaneous and stimulated atrial events and spontaneous and stimulated ventricular events; means for stimulating a patient's left and right ventricles; means for calculating of an atrioventricular delay (AVD) having a duration counted from a detection of one of a spontaneous and stimulated atrial event; means for delivering a ventricle stimulation pulse in the right ventricle in the absence of detected spontaneous ventricular event during the calculated AVD; means for calculating an inter-ventricular delay (VVD) between delivery of stimulation pulses in the patient's left and right ventricles; and means for collecting of an endocardial acceleration (EA) signal representative of movements produced by cyclical contractions of the patient's atrial and ventricular cavities; wherein the means for calculating the AVD and the means for calculating the VVD further comprise: means for identifying and isolating in the collected EA signal a component EA4 that corresponds to the fourth peak of the EA signal associated with the atrial activity, and a means for measuring a first measure of a temporal parameter related to the time interval between the atrial event detection and a marker related to the EA4 component that immediately follows the atrial event detection; means for identifying and isolating in the EA signal a component EA1 that corresponds to the first peak of the EA signal associated with the ventricular isovolumetric contraction, and a means for measuring a second measure of one of a non-temporal parameter related to the peak amplitude or a signal energy of the EA1 component; means for determining an optimal AVD (AVDO) as a function of said first measure, said AVDO being calculated for each of a plurality of different values of VVD, so as to obtain a plurality of pairs of values {AVDO, VVD} and means for selecting, among said plurality of pairs of values {AVDO, VVD}, one of said pairs of values based on said non-temporal parameter related to the EA1 component.