A dual chamber cardiac pacemaker has a pulse controller for delivering
stimulation pulses to the ventricle of a heart, a ventricular sensor for
sensing ventricular depolarization, and a unit for identifying a
beginning of an A-V interval of the heart. The pulse controller causes a
ventricular stimulation pulse to be generated at a predetermined energy
level after the expiration of a predetermined A-V interval. The
controller prolongs the A-V interval under certain circumstances. Upon
the expiration of the prolonged A-V interval, the pulse controller causes
the ventricular pulse generator to emit a ventricular stimulation pulse
at a higher energy level than the predetermined energy level to evoke a
response in the ventricle. This allows the intrinsic heart activity to be
detected and utilized, while ensuring safe pacing, as well as successful
and reliable stimulation and maintaining a low power consumption during
normal operation.