Pacemaker device

A method for providing cardiac pacing to a patient, comprising:

• determining timing electrical stimulus signals temporally modulated by a respiration signal, the method comprising:
• receiving a first input signal indicative of respiration;
• determining, from the first input signal, a signal indicative of instantaneous respiration duty cycle;
• and
• generating a timing information for the electrical stimulus signals as a function of the signal indicative of instantaneous respiration duty cycle such that a bias is maintained towards synchronization between a respiration period and an integer ratio of the periods between the electrical stimulus signals,
• generating electrical stimulus signals based on the timing information;
• and
• applying the electrical stimulus signals to a heart of the patient thereby causing cardiac muscle contraction to pump the heart of the patient.