Cycle to cycle adjustment of the stimulation amplitude for an active implantable medical device

An active implantable medical device comprising:

• means for stimulating the ventricle, to deliver to the heart a stimulation pulse presenting a predetermined pulse amplitude and duration,
• means for adjusting the stimulation pulse amplitude,
• means for periodically evaluating a capture threshold and defining a corresponding safety amplitude, said safety amplitude being greater than said capture threshold;
• means for detecting a capture cycle to cycle, and determining a detection or a loss of capture on each cardiac cycle after a stimulation pulse having a given stimulation amplitude;
• and
• means for defining a capture amplitude that is in a range between the capture threshold and the safety amplitude;
• wherein the means for adjusting the stimulation pulse amplitude further comprises:
• means for temporarily reducing the stimulation amplitude below the safety amplitude toward the aforementioned capture amplitude;
• and
• means for checking, immediately after a stimulation with said reduced stimulation amplitude, the detection or loss of capture, and, in the event of a detected detection of capture, establishing for a next cardiac cycle the stimulation amplitude at the capture amplitude, and in the event of a detected loss of capture, increasing the capture amplitude.