Abstract: An implantable medical device includes a mechanical activity sensor configured to sense movements produced by contractions of a ventricular cavity and output a mechanical activity signal representative of the contractions. The implantable medical device also includes one or more circuits configured to detect a plurality of spontaneous ventricular depolarizations based on electrical potentials representative of the spontaneous ventricular depolarizations, calculate an escape interval, and provide an antibradycardia ventricular pacing therapy in an absence of a detected spontaneous ventricular event after the escape interval.

Abstract: A method for making an hermetic and electrically insulating feedthrough in the metal wall of a housing of a device, preferably of an active medical device, is disclosed. The method includes: a) forming electrically insulating layers (24, 26) on each of the internal and external sides of the wall (10), b) on the internal side of the wall, forming a non-through groove with a closed contour (30) defining in the wall a metal islet (28) that is physically and electrically isolated from the rest of the wall, by removing the entire thickness of the electrically insulating internal layer (26) and the wall (10), leaving intact a sufficient thickness of the electrically insulating external layer (24) so that the external layer mechanically supports the metal islet, and c) on the external and internal sides respectively, exposing pads (34, 36) for making an electrical contact to the metallic islet, by a localized removal of material of the electrically insulating external and internal layers (24, 26), respectively.

Abstract: One embodiment of the invention relates to a multipolar lead for implantation in a venous, arterial, or lymphatic network, and for use with an electric stimulation or detection device. The invention includes at least two microcables, each having a central conductor for connection to the electric stimulation or detection device. The invention further includes a first ring having at least two lumens, each sized to receive a microcable of the at least two microcables, wherein one of the at least two lumens is a connection lumen which receives a first microcable of the at least two microcables. The ring further includes a connection element movable into the connection lumen to pierce a sheath of the first microcable and to press into the central conductor of the first microcable received by the connection lumen, electrically connecting at least a portion of the first ring to the central conductor.

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: An active medical device using non-linear filtering for the reconstruction of a surface electrocardiogram (ECG) from an endocardial electrogram (EGM) is disclosed. The device for the reconstruction of the surface ECG includes a plurality of inputs, receiving a corresponding plurality of EGM signals from endocardial or epicardial electrogram (x1[n], x2[n]), each collected on a respective EGM derivation of a plurality of EGM derivations, and at least one output delivering a reconstructed surface ECG electrocardiogram signal (y[n]), related to an ECG derivation, and a non-linear digital filter (12?, 12?, 14) with a transfer function that determines the reconstructed ECG signal based on said plurality of input EGM signals. The non-linear digital filter includes a Volterra filter type (12, 12?, 12?) whose transfer function includes a linear term (h1) and at least one quadratic (h2) and/or cubic (h3) term(s).

Abstract: A method of implanting a lead in the left heart cavity includes introducing the lead into the right heart cavity. The lead includes a lead body having a deformable sheath, a proximal end having an electrical connector, a distal end including a projecting helical screw electrode, and a conductor extending along the sheath, electrically connecting the electrical connector and the helical screw. The method further includes positioning the distal end of the lead to abut a septum wall between the right and left heart cavity. The electrical connector is connected to an RF puncture generator and RF energy is applied to the screw while providing rotational movement to the screw for advancement through the septum wall. The method further includes positioning the screw at a target stimulation site in the left heart cavity and providing rotational movement to the screw to anchor the lead at the target site.

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, 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: An intracorporeal autonomous active medical device having a capsule body and a base. The capsule body includes a body portion and a lid portion, and the capsule body contains therein electronic circuitry containing the active elements of the autonomous medical device, and a power supply. The capsule body also includes a fastening system on an exterior surface of the capsule body that is configured to correspond with a fastening mechanism on the base configured to be anchored to a tissue wall. The fastening mechanism provides selective engagement between the capsule body and the base.

Abstract: An epicardial stimulation lead includes a lead body having a connector at a proximal end for coupling the lead to a generator of an active implantable medical device. The lead also includes a distributor housing at a distal end of the lead body and means for anchoring the distal end of the lead body to the epicardium. The lead also includes an active part having a plurality of microcable conductors, the proximal ends being coupled to the distributor housing, the distal ends being free. Each microcable has a diameter of at most equal to 2 French. Each microcable includes at least one denuded area in the insulating coating forming a stimulation electrode adapted to contact or penetrate an epicardium wall. Each microcable also includes a transverse elongated member extending at an angle relative to the main direction of the microcable for penetrating into the epicardial wall.

Abstract: An implantable cardiac stimulator includes at least one first sensing unit for detecting intrinsic cardiac activities of a first ventricle, at least one ventricular stimulation unit for stimulating a second ventricle, and a stimulation control unit connected to the first sensing unit. The stimulation unit processed output signals of the first sensing unit and generates control signals for the stimulation units. The stimulation control unit derives a current intrinsic RR interval from detected ventricular intrinsic cardiac activities R of the first ventricle, and to determine from the RR interval a delay interval ?, which begins with a ventricular event of the first ventricle and at the end of which the stimulation control unit triggers a stimulation of the second ventricle (unless it is suppressed).

Abstract: An implantable medical device includes a sensor configured to generate an endocardial acceleration (EA) signal representative of activity of a patient's heart. The device further includes one or more circuits configured to identify within the EA signal at least one EA signal component corresponding to at least one peak of endocardial acceleration, and extract from the at least one EA signal component at least two characteristic parameters. The one or more circuits are further configured to generate a composite index based on a combination of the at least two characteristic parameters, determine a plurality of values of the composite index for a plurality of pacing configurations, and select a current pacing configuration from among the plurality of pacing configurations based on the plurality of values of the composite index.

Abstract: An overvoltage protection element, provided as a component of a medical device (3) used on or in a human or animal body, reduces power absorption upon application of an external overvoltage signal having chronological rising and/or decay characteristic at an interface (15) of the medical device (3). The overvoltage protection element has reshaping means (17) which convert the external overvoltage signal at the interface (15) into an internal voltage pulse, and limiting means (19) which limit a voltage drop on at least one electronic component of the medical device to a predetermined limiting value.

Abstract: A universal programming device for individualized patient medical devices such as implants has an RF transceiver (transmitter/receiver), a control unit, and a man-machine interface (or a connection for a man-machine interface). The RF transceiver is configured to receive and transmit data in the MICS frequency band. The control unit is connected to the transceiver and has preconfigured software interfaces, such that the programming device can be expanded by addition of control software modules. The preconfigured software interfaces define a uniform interface for triggering the transceiver, which the control software modules can access. The man-machine interface, e.g., a keyboard and/or a display (and/or the connection for such a man-machine interface) is connected to the control unit.

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: A lead for active implantable medical devices comprising a chip, notably for electrode multiplexing. The lead (10) includes an insulating supporting tube (20) interposed in a flexible elongated tube, with a central bore (22) coaxial with the lumen of the lead. The supporting tube comprises on its surface at least one crossing conductive strip (28) extending in the axial direction. A chip (18) on a flexible substrate is disposed with a bent or curved conformation in a receptacle of the supporting tube isolated from the conductive strip. An electrode, e.g., for cardiac sensing/pacing, (16) on the supporting tube (20) is electrically connected to an outer conductive pad (24) of the chip. The conductive strip is connected (i) at each end (28b), face to face to a conductive connection (12), housed in the sheath, and (ii) in a central region (28a), to an inner conductive pad (26) of the chip.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. This lead (24) includes a lead body with a hollow sheath (26, 28) of deformable material, having a central lumen open at both ends, and at least one telescopic microcable (42) of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end (32) thereof. The party emerging beyond the distal end is an active free part (34) comprising a plurality of distinct bare areas (36, 38, 50, 50?, 50?), intended to come into contact (40) with the wall of a target vein (22) of the coronary system (14-22), 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 method for powering an autonomous intracorporeal leadless capsule includes the step of receiving a slow pressure variation at an external surface of a deformable member on the capsule. The deformable member is displacing in response to the slow pressure variation. The method further includes using a high pass mechanical filter to prevent the displacement from being transferred to an energy harvesting circuit within the capsule. The method further includes receiving a fast pressure variation at the external surface of the deformable member on the capsule, the deformable member displacing in response to the fast pressure variation. The method further includes via the high pass mechanical filter, passing the displacement to the energy harvesting circuit and creating energy using the displacement provided to the energy harvesting circuit.

Abstract: A device produces at least two distinct temporal components (Vbip, Vuni) from two separate endocardial electrogram (EGM) signals concurrently collected. The capture test determines a non-temporal 2D characteristic (VGM) representative of the cardiac cycle to be analyzed. The VGM is constructed using variations of one of the temporal components (Vuni) according to the other (Vbip). The devices determines the presence or absence of capture by analysis of this characteristic relative to a two dimensional domain.

Abstract: Performing a capture test on a stimulated cardiac cycle based on the analysis of a cardiac vectogram using an active medical device including circuits and control logic for delivering electrical stimulation pulses to a heart chamber; collecting electrical activity of the heart chamber and producing two distinct temporal components (Vbip, Vuni) from two distinct intracardiac electrogram EGM signals from the heart chamber. The capture test detects an occurrence of a depolarization wave induced by the stimulation of the heart chamber, and determines a two-dimensional non-temporal characteristic (VGM) representative of the stimulated cardiac cycle, from the variation of one of the temporal components (Vuni) versus the other temporal component (Vbip). A bi-dimensional analysis delivers at least one descriptor parameter of the two-dimensional non-temporal characteristic, and determines a presence or loss of a capture based on the at least one descriptor parameter.

Abstract: An active implantable medical device (e.g., implantable pacemaker or defibrillator), for detection of QRS complexes in noisy signals. Functional units (12-16) collect, amplify, prefilter and convert from analog-to-digital an endocardial signal, and digital functional units (18) provide signal processing and analysis of the digitized signal, for delivery of an indicator corresponding to a signal peak detection representative of the presence of a QRS complex in the endocardial signal. A double threshold comparator (30) is employed, receiving as input (28) the digitized signal and outputting (40) the indicator of peak detection when, cumulatively: the amplitude (A) of the input signal exceeds a peak amplitude threshold (SA), and the peak amplitude threshold is exceeded for a period (W) greater than a peak width threshold (SW). The peak amplitude threshold (SA) is a variable adaptive threshold, according to a noise level calculated from the energy (RMS) of the input signal.