Abstract: The device includes a cardiac therapy circuit with a first terminal, and a peripheral therapy circuit with a second terminal. These terminals can either receive a cardiac detection/stimulation lead and a peripheral detection/stimulation lead of an anatomical structure. The device is configured to recognize the leads and automatically configure the connection terminals. This includes discrimination methods for identifying the terminal on which a cardiac signal is detected, and switching methods for coupling the cardiac therapy circuit to the terminal and the peripheral therapy circuit to the other terminal.

Abstract: A system for assessing a sympathovagal balance of a patient includes a generator configured to produce stimulation pulses, a stimulator that receives the stimulation pulses produced by the generator and outputs a stimulation energy, a sensor configured to measure a physiological signal, and a processor. The processor is configured to control the generator during a plurality of sequences to produce the stimulation pulses over a test period, determine a biological parameter of a current activity of the patient derived from the physiological signal, determine a variation of the biological parameter resulting from the stimulation pulses, and determine a sympathovagal balance index according to the variation in the biological parameter.

Abstract: A medical device includes a VNS pulse burst generator for stimulation of the vagus nerve, and a controller for analyzing the cardiac rhythm. It further includes a sequencer that uses an estimator to calculate during a given cycle an estimate of the temporal position of the R wave of the next cycle. The controller is configured to define the moment of application of the VNS pulse burst as an instant corresponding to the estimate minus a predetermined advance delay. VNS therapy is thus delivered in a non-vulnerable period, near the end of the period of natural ventricular escape.

Abstract: A retractable screw-type stimulation or defibrillation intracardiac lead is disclosed. According to one embodiment, the lead comprises a flexible hollow sheath (12) having at its distal end a lead head (10) and a connector (66) at its proximal end. The connector comprises a pin (62) connected to a lead head electrode (18). The lead head comprises a tubular body (28), at least one electrode (18, 20) for stimulation or defibrillation, a moving element translationally and rotationally moving within the tubular body in a helical motion, and an anchoring screw (24) axially moving with respect to the tubular body, and a deployment mechanism (22) to deploy the anchoring screw out of the tubular body (28).

Abstract: The system includes an active medical device with means for delivering defibrillation shocks; means for continuous collection of the patient current cardiac activity parameters; and evaluator means with neuronal analysis comprising a neural network with at least two layers. This neural network comprises upstream three neural sub-networks receiving the respective parameters divided into separate sub-groups corresponding to classes of arrhythmogenic factors; and downstream an output neuron coupled to the three sub-networks and capable of outputting an index of risk of ventricular arrhythmia. The risk index is compared with a given threshold, to enable or disable at least one function of the device in case of crossing of the threshold.

Abstract: The disclosure relates to a device including a plurality of electrodes for stimulation of both ventricles with application of an atrioventricular delay and of an interventricular delay, a processor configured to multidimensionally measure an interventricular conduction delay, and monitor the evolution of a patient's condition. For the multidimensional measurement of the interventricular conduction delay, the device produces stimulation of one of the ventricles and collects, in the other ventricle, two endocardial electrogram signals on separate respective channels, giving two respective temporal components. Both temporal components are combined in one single parametric 2D characteristic representative of the cardiac cycle, and a comparison is made with reference descriptors for deriving an index representative of the evolution of the patient's condition.

Abstract: According to some embodiments, a device operates by comparative morphological analysis of depolarization signals collected in spontaneous rhythm on separate respective channels, with two temporal components combined into a single 2D parametric VGM vectogram characteristic. Similarity quantification methods evaluate a variation over time of a descriptor parameter of a current VGM compared to a stored previous reference VGM. This variation is compared with predetermined thresholds to diagnose an occurrence of remodeling or reverse remodeling in a patient, and/or to detect a lead failure or an occurrence of ischemia. The descriptor parameter is a function of a velocity vector of the VGM, a comparison relating to a correlation coefficient between respective magnitudes of a current VGM velocity vector and of a reference VGM velocity vector, and an average angle between these respective velocity vectors.

Abstract: An atraumatic detection/stimulation lead is disclosed. The lead includes at least one microcable having a core cable comprising a plurality of elementary metal strands. One of the microcables has provided at its distal end an atraumatic protection device. The atraumatic protection device includes a protective coating on the distal ends of the elementary strands of the microcable, and the protective coating is covered by a protective cap of deformable material. The protective cap may be a conical distal end adapted to deform and axially flatten out. The microcable may have an overall diameter less than or equal to 1.5 French (0.50 mm).

Abstract: An RF telemetry receiver circuit for active implantable medical devices. The baseband binary signal (Db) is doubly modulated by a low frequency carrier (Fm) and by a high frequency carrier (Fc). The receiver circuit is a semi-passive non heterodyne circuit, devoid of a local oscillator and mixer. It comprises an antenna (104), a passive bandpass filter (108) centered on the high-frequency carrier (Fc), a passive envelope detector (120-126) and a digital demodulator (116). The envelope detector comprises a first diode circuit (120) of non-coherent detection, an active bandpass filter (122) centered on a frequency (2.Fm) twice the low frequency carrier and having a bandwidth (2.Db) twice the baseband bandwidth, and a second diode circuit (124) of non-coherent detection, outputting a baseband signal applied to the digital demodulation stage (116).

Abstract: A microlead has a distal active portion formed by a microcable including an electrically conductive core coated with an insulation layer, with a plurality of exposed areas forming the stimulation electrodes. The microcable has a three-dimensional preshape inscribed in a cylindrical envelope volume so as to match the target vessel wall. The microcable includes a plurality of exposed areas regularly distributed over the circumference of the cylindrical envelope volume considered in axial projection, the exposed zones extending only over an angular sector of the microcable considered in cross section, said angular sector facing the outside of the envelope volume of the preshape.

Abstract: A cardiac implant includes a classifier configured analyze the data for comparison to thresholds prioritized according to a Boolean decision tree. The implant can generate an indicator of alert status (i.e., alert or no alert). A supervisory device operated, for example, by a doctor can associate each indicator a marker (AE/no AE) indicating the presence or absence of an observed adverse event. In the presence of a false positive, a command for update of the thresholds of the decision tree is transmitted to the implant. A database of reference patients can be used to recreate or further update the decision tree to avoid the occurrence of false negatives.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. The lead includes a lead body with a hollow sheath of deformable material, having a central lumen open at both ends, and at least one telescopic microcable of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end thereof. The part emerging beyond the distal end is an active free part comprising a plurality of distinct bare areas, intended to come into contact with the wall of a target vein of the coronary system, so as to form a network of stimulation electrodes electrically connected together in parallel. The microcable further comprises, proximally, a connector to a generator of active implantable medical device such as a pacemaker or a resynchronizer.

Abstract: A medical monitoring and communication system for wireless communication between an implantable medical device, a mobile user device, and a remote server includes a sensor device coupled to the implantable medical device. The sensor device is configured to default to a master mode prior to pairing with the mobile user device, listen for a request to connect from the mobile user device, refrain from communicating with the mobile user device responsive to the request to connect from the mobile user device being invalid, and switch to a slave mode to allow cooperative pairing with the mobile user device responsive to the request to connect from the mobile user device being valid. The mobile user device facilitates communication between the sensor device and the remote server when the mobile user device and the sensor device are cooperatively paired.

Abstract: A device includes a hemodynamic sensor measuring blood flow in the left chambers of a myocardium, at least one motion sensor measuring a displacement of the walls of the left ventricle of the myocardium, a first analysis module determining a time of closure of the aortic valve based on a signal of the hemodynamic sensor, a second analysis module determining a time of peak contraction of the left ventricle based on a signal from the motion sensors, and a third analysis module determining a time between the moment of peak contraction of the left ventricle and the moment of closure of the aortic valve. If the peak of contraction of the left ventricle is after the instant of closure of the aortic valve, the device adjusts the inter-ventricular delay and/or the atrioventricular delay to minimize or cancel the time disparity.

Abstract: The present invention relates to an active medical device that uses non-linear filtering for reconstructing a surface electrocardiogram from an endocardial electrogram. At least one endocardial EGM electrogram signal is collected from of samples collected from at least one endocardial or epicardial derivation (71?, 72?, 73?), and at least one of a reconstructed surface electrocardiogram (ECG) signal through the processing of collected EGM samples by a transfer function (TF) of a neural network (60?). The neural network (60?) is a time-delay-type network that simultaneously processes said at least one endocardial EGM electrogram signal, formed by a first sequence of collected samples, and at least one delayed version of this EGM signal, formed by a second sequence of collected samples distinct from the first sequence collected samples. The neural network (60?) provides said reconstructed ECG signal from the EGM signal and its delayed version.

Abstract: Optimized RF telemetry transmission between an active implantable medical device and a remote external receiver in which the information to be transmitted are grouped by class (TYPE 0, TYPE 1, . . . , TYPE n) according to a criticality index (IC) defining a priority rank as between the different information classes to be transmitted. A plurality of modulation schemes and of data rates characterize different transmission configurations, each with a reliability index inversely related to the probability of failure of transmission in a noisy environment. The criticality indexes of the highest priorities are assigned to the transmission configurations with the higher reliability indexes. On an information transmission request, an RF telemetry transmission configuration is selected (52-62) depending on the criticality index characterizing the information to be transmitted. The transmission is operated (64, 66) with the transmission configuration thus selected.

Abstract: An intracardiac capsule comprises a cylindrical body having an atraumatic rounded surface and a helical anchoring screw integral with the cylindrical body. The helical anchoring screw is able to penetrate tissue of a wall of the heart and is configured to provide temporary attachment, in rotation and in translation, of the capsule to an implantation site. The helical anchoring screw surrounds at least a portion of the length of the cylindrical body forming a contact region intended to come into contact with the wall of the cavity of the heart. Over the length of the contact region, the external diameter of the cylindrical body is less than the inner diameter of the helical anchoring screw, so as to leave a free gap there between. The helical anchoring screw is secured to the cylindrical body near the proximal end of the contact region, and extends freely to the opposite distal end.

Abstract: Devices for use in providing stimulation to cardiac tissue are provided. One device is configured for implantation in or near the heart and includes a flexible, elongate body. The body is configured to be positioned across two different sections of the vasculature such that (a) the first end can be positioned in a first section of the vasculature through which the device can stimulate a first chamber of the heart and (b) the second end can be positioned in a second section of the vasculature through which the device can stimulate a second chamber of the heart. The device further includes a receiver circuit configured to receive signals wirelessly from a transmitter device and to convert the signals into electrical power. The device also includes at least a first set of one or more electrodes configured to stimulate the heart using the electrical power.

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. One method includes collecting, using an implantable device, reference episodes; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate a heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

Abstract: An active medical device is configured to receive inputs and to calculate a hemodynamic parameter representative of myocardium contractility determined from an endocardial acceleration signal. The microcontroller acquires heart rate and hemodynamic parameter pairs of values during a plurality of cardiac cycles. The microcontroller is configured to distribute the pairs of values into discrete bins to develop a profile for analysis. The microcontroller is configured to conduct an analysis comprising calculating an index representative of the patient's clinical status. The hemodynamic parameter representative of the myocardial contractility is a time interval separating the first and the second peak of endocardial acceleration.