Abstract: An epicardial screw lead for stimulation/defibrillation implantable by a guide-catheter inserted into the pericardial space is described. The lead is a monodiameter lead with a helical anchoring screw extending axially of the lead body. The guide-catheter (24) has a pre-shaped tube having, in the absence of stress, a first bend (26) for supporting the lead body on the outer wall of the pericardial space (38), and a second bend (28) for orienting the end of the guide-catheter tube in the direction of the outer wall of the myocardium (34) and keeping the axis of the anchoring screw (14) in that same direction during a combined movement of screwing and insertion of the lead head.

Abstract: An active implantable medical device for vagal stimulation with optimization of ventricular filling is disclosed. The device delivers stimulation pulses to the vagal nerve of the patient with an adjustable energy level. The device includes a hemodynamic sensor for measuring hemodynamic parameters of the patient's cardiac cycles and delivering a timing parameter representative of the ventricular filling time. The energy level of the vagal stimulation pulses is adjusted dynamically and repeatedly over several cardiac cycles. The energy level is varied during successive cardiac correlative changes in the filling time (FT1, FT2) are assessed, and the energy level is set to a level that maximizes the ventricular filling time.

Abstract: A medical device for stimulating the heart using biventricular stimulation. The device includes a sensor for detecting an endocardial acceleration parameter and a processing circuit configured to receive the endocardial acceleration parameter. The device further includes stimulation electronics coupled to the processing circuit. The processing circuit is configured to use the EA parameter to evaluate the biventricular stimulation. The evaluation includes comparing the value of the EA parameter in biventricular mode to the value of the EA parameter in left only mode or right only mode, and using the comparison and an assessment of the variability of the EA parameter as a function of the AVD in the left or right mode to distinguish between cases comprising: (a) normal operation, (b) a loss of RV or LV capture, (c) possible anodal stimulation. The processing circuit is further configured to conduct at least one update to operational parameters of the device based on the determined case.

Abstract: A device includes a pulse generator coupled to a neurostimulation lead placed around the nerve and a set of electrodes individually connected to the generator by a splitter circuit controlled to preferentially stimulate certain regions of the nerve relative to other regions. The device performing an iterative search of an optimal configuration operating by selection of a plurality of different stimulation configurations, storing of a cardiac physiological parameter measured for each selected stimulation configuration, and designation as optimal stimulation configuration of the one of said selected different stimulation configurations, depending on at least the stored values of the physiological parameter measured for different electrode configurations.

Abstract: A data management system operating within a third-party spreadsheet application environment includes a plurality of template worksheets within the third-party spreadsheet application. The plurality of template worksheets comprise at least a dashboard interface worksheet, and at least one settings interface, generated by at least one processor, comprising at least one worksheet within the third-party spreadsheet application. The at least one settings interface further comprising a plurality of selectable settings options configured to modify at least one parameter of the dashboard interface worksheet, wherein the dashboard interface worksheet comprises a plurality of selectable dashboard options comprising at least one of the following: a choose columns to display option, an insert contact option, a delete contact option, a sort ascending option, a sort descending option, a hide averages option, a hide totals option, an import contacts option, an export contacts option, and/or a clear sorting option.

Abstract: A pacing lead having a lead body comprising a hollow sheath by a first lumen and an extension body extending from the lead body, the extension body having a proximal end and a distal end, the distal end having an active lead region. The extension is traversed by a second lumen, the second lumen communicating with the first lumen of the lead body so as to receive a guide wire for the implantation of the lead. The extension has an outside diameter of between 1 and 3 French. The extension distal end comprises at least one electrically isolated peripheral conductor electrically insulated except for at least two denuded areas on an outer surface of the conductor to contact a wall of a target vein, so as to form a network of stimulation electrodes electrically connected together. The lead body proximal end includes an electrical connection for the peripheral conductor.

Abstract: This device includes a sensor of endocardiac acceleration EA and one or more circuits configured for: extracting from the EA signal a predetermined EA parameter, determining a period of sleep, evaluating the clinical condition of the patient based on the EA parameter variations on this sleep period, and issuing an alert of worsening of the patient's condition. The device further determines a variability index of the EA parameter on the sleep period, and then calculates a ratio between this calculated variability index and a reference value, and delivers this ratio as a clinical status index. The alert signal is generated by the crossing by this ratio of a predetermined alert threshold.

Abstract: An active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison.

Abstract: A device includes a lead configured to for use in applying an atrioventricular delay (“AVD”), an acceleration sensor adapted to output an endocardial acceleration signal, and circuitry configured to receive and process said endocardial acceleration signal to provide ventricular pacing by varying, in a controlled manner, the AVD in a range having a plurality of AVD values. The circuitry derives from said endocardial acceleration signal a value of a parameter representative of an component of the endocardial acceleration signal corresponding to the first endocardial acceleration peak associated with an isovolumetric ventricular contraction (“EAX component”), and evaluates a degree of variation of said parameter values as a function of said plurality of AVD values to detect atrial and ventricular events.

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: A method of manufacturing a detection/stimulation lead for implantation into a venous, arterial, or lymphatic network is shown and described. The method includes providing a microcable comprising a sheath of insulating material covering an electrically conductive core. The method further includes surrounding a portion of the microcable with an electrically conductive metal ring. The method also includes crimping the ring such that the thickness of the sheath is penetrated by a portion of the metal ring and such that an electrical connection is formed between the metal ring and the electrically conductive core.

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 intracorporeal capsule for placement in a heart and for energy harvesting using blood pressure variations is shown and described. The capsule includes a capsule body and a piezoelectric strip coupled to a rigid surface for receiving blood pressure force. The piezoelectric strip is normally perpendicular to the direction of the force on the rigid surface. The piezoelectric strip is disconnected from the capsule body along at least two edges of the piezoelectric strip such that the blood pressure force can move the rigid surface, and thereby deform the piezoelectric strip for energy harvesting.

Abstract: A biventricular cardiac stimulator has a right-ventricular sensing unit, having or connected to a terminal for a right-ventricular sensing electrode, a left-ventricular sensing unit, having or connected to a terminal for a left-ventricular sensing electrode, and a pacemaker timer, which is connected to the right-ventricular sensing unit and the left-ventricular sensing unit.

Abstract: The present invention relates to an electrode (30,30?) for implantation in contact with a neural tissue, said electrode extending along an axis, said neural tissue being capable of generating one or more action potentials, and said one or more action potentials propagating with a given speed in said neural tissue. The electrode comprises a carrier (31, 31?) of biocompatible electrically insulating material; stimulation electrode contacts (32a; 32?a; 32b; 32?b) deposited on a surface of said carrier (31, 31?) for applying an electrical stimulation to said neural tissue so as to generate, after a given latency time, a compound action potential when stimulated by said electrical stimulation; one or more sensing electrode contacts (33a; 33b; 33c; 33?a; 33?b; 33?c) deposited on said surface of said carrier and provided at a distance from said stimulation electrode contacts, said sensing electrode contacts being adapted to be connected to measuring means (23) having a given inactive period.

Abstract: A system for stimulation/defibrillation of the left ventricle endocardially or from a vein in the coronary system including: a lead body (10) having a lumen, a distal end (12) with an anchor (14) connectable to a wall of a heart chamber or of a vein of the coronary system, and a proximal side with a connector (22) having a first terminal (26). The lumen of the lead houses a microcable (28) with an active free part (30) that emerges from the distal end. An insert (38) formed on the lead body includes a first electrical connection to the first terminal (26) of the connector, and a coupler selectively movable between (i) a released position wherein the microcable is free to slide in lumen of the lead body, and (ii) a closed position, wherein the microcable is both mechanically immobilized in the lead body and electrically connected to first electrical connection.

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.

Abstract: This implantable microcatheter includes a hollow tube with a central lumen extending throughout the length of the tube from a proximal region to a distal region. The bending stiffness of the proximal region is greater than the bending stiffness of the distal region, and the tube has a transition region having a decreasing stiffness gradient from the proximal region to the distal region. The tube wall is free of shielding or armor at least in the distal region, and the catheter is made of biocompatible material(s) suitable for a permanent implantation in venous, arterial or lymphatic networks.

Abstract: A stimulation lead is disclosed. This lead comprises a lead body having a lumen housing an inner conductor, the conductor being axially and rotationally movable within the lumen, and coupled to a generator of an active implantable medical device. The lead also has a helical anchoring screw extending from a distal end configured to penetrate target tissue, and a stimulation needle electrically coupled to the conductor and comprising at its distal end an active free portion with at least one stimulation electrode for application of pacing pulses to the target tissue. The stimulation needle is axially movable between a retracted position inside the tubular body, and a deployed position with the active free portion of the needle emerging out of the tubular body, utilizing an actuating mechanism for moving the needle from its retracted position to its deployed position under the effect of rotary movement relative to the lead body.

Abstract: An extracorporeal physiological measurement device is disclosed, having fastening means for attaching to the body of a person or animal, measurement means for detection of values of a physiological measured variable on the body, and movement-detecting means and measured-value-influencing means connected thereto at the input for influencing the detected measured values before processing or storage as a function of a position or movement status of the body or the measurement device detected by the detection means such that the measured-value-influencing means have a unit for detection of a shift in position between the measurement device and the body.