Implantable cardiac prosthetic for resynchronization by biventricular pacing using reverse remodeling

An active implantable medical device for cardiac resynchronization comprising:

• Means for detecting atrial and ventricular events;
• Means for applying electrical pulses to preselected stimulation sites of the right and left ventricles;
• Means for calculating an atrioventricular delay (AVD);
• Means for calculating an interventricular delay (VVD);
• wherein a combination of the stimulation sites, the AVD and the VVD together define a pacing configuration;
• Means for collecting an endocardial acceleration (EA) signal;
• Means for measuring a peak to peak amplitude (PEA (i)) of the first peak of endocardial acceleration (PEA) for each cardiac cycle (i) and
• Switching means for changing in a controlled and temporary manner the current pacing configuration, from an original pacing configuration (a) to a changed pacing configuration (b);
• Means for assessing, in the changed pacing configuration b, a data set comprising:
• a maximum value (P (b, a)) of the amplitude of the PEA achieved during a first time period after the change of pacing configuration;
• an average value (A (b, a)) of the PEA, calculated for a predetermined number of cardiac cycles starting after a second time period after the pacing configuration change;
• a variability (V (b, a)) of the PEA around said average value of PEA, and
• a duration (T (b, a)) of a third time period after the pacing configuration change corresponding to a stabilization.