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Abstract

An active implantable medical device, particularly of the cardiac pacemaker, defibrillator and/or cardiovertor type, having a function of dual chamber cardiac stimulation and a mode of fallback in which a mode of de-synchronisation of the ventricular stimulation occurs when the atrial rhythm exceeds an acceptable level, and a mode of progressive re-synchronisation occurs in the case of a return of the atrial rhythm to the acceptable level. The re-synchronisation is controlled in a conditional manner to be triggered and maintained only if (a) one detects no trouble of the atrial rhythm. In an alternate embodiment the re-synchronisation is triggered and maintained only if, in addition to condition (a): (b) one detects (20) the presence of an effective sinus rhythm. In another alternate embodiment, the re-synchronisation is triggered and maintained only if, in addition to conditions (a) and (b): (c) one determines that the duration between the end of the post-atrial atrial refractory period and the end of the atrial escape interval is at least equal to a predetermined duration during a number of successive cycles in the course of the re-synchronisation mode.

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