| 摘要 |
A rate responsive active implantable medical device having at least one effort sensor, measuring a parameter which is predominantly physiological (VE) and delivering an output signal which is a function of the effort developed by a patient carrying the device, and at least one activity sensor, measuring a parameter which predominantly physical. The devices operates to (a) measure periodically at the two sensors "couples of values" (12, 14, 16; 22, 24, 26) corresponding to a given level of effort developed by the patient; (b) establish a characteristic function of the measured couples of values (10, 20), and (c) evaluate over the course of time this established characteristic, by seeking a possible increase in the signals delivered by the effort sensor as compared to the signals delivered by the activity sensor, indicative of the patient's metabolic demand (cardiac output requirements). The device preferably is implemented in a multisite type pacemaker in which the control of stimulation and/or the configuration of the stimulation sites is modified in the even of an excessive increase in the metabolic demand of the patient.
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