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.

Abstract: A sensing/pacing lead including a microcable having a diameter of at most 2 French (0.66 mm). The microcable includes an electrically conductive core cable including a plurality of strands and a composite structure formed from at least a structuring material and a radiopaque material, the radiopaque material constituting at least about 0.008 mm2 of the core cable cross section. The plurality of strands of the core cable comprises a first set of individual strands formed from the structuring material and a second set of individual strands formed from the radiopaque material, or a plurality of strands each comprising a first and second layer, one of which is the structuring material and the other the radiopaque material. The microcable further includes a polymer insulation layer at least partially surrounding the core cable and at least one electrode.

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 (46), and the energy level is set to a level that maximizes the ventricular filling time.

Abstract: A pacing lead (20) having a lead body (22) with a central lumen and provided with structure for retaining the lead body to a wall of the coronary network, and a hollow tubular extension (26), bearing an active region of the lead and also traversed by a central lumen (28) communicating with the inner lumen of the lead body, so as to allow implantation by an over the wire technique. The hollow tubular extension has an outside diameter of between 2 and 3 French (0.66 and 1 mm) to allow implantation deep in the coronary sinus network, and it comprises on its outer surface an electrically insulated peripheral conductor, except for denuded areas intended to come into contact with the wall of a target vein and form a network of stimulation electrodes (32, 34) electrically connected together.

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 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 multizone epicardial pacing lead (10) having a lead body (12) with a proximal connector (14) for coupling to a generator of an active implantable medical device and, distally, an anchor to an epicardium wall and an active part comprising a plurality of stimulation electrodes, coming into contact with, or penetrating, the epicardium wall. This active part comprises a distributor housing (16) and a network of flexible microcables (18) radiating from the housing. Each microcable is formed of an electrically insulated conductor comprising at least one denuded area (20), each of these areas forming a stimulation electrode.

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. A method in this context includes collecting, using an implantable device, reference episodes, the reference episodes comprising, at least one of: electrical activity signals of a myocardium; myocardium hemodynamic activity signals, or indicators reflecting variation of physical parameters, variation of activity, and variation of hemodynamic phases between phases of effort and phases of recovery; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate an early heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

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 lead for an implantable cardiac prosthesis is disclosed. The lead has integrated protection against the effects of magnetic resonance imaging (“MRI”) fields. A protection circuit (26) may be placed at the distal end of the lead comprises a resistive component (28) interposed between the electrode (E1, E2) and the distal end of the conductor (22, 24) associated with this electrode. A normally-open controlled active switch (34, 36) may allow in its closed state to short-circuit the resistive component. A control stage (32) may be coupled to the conductors and detect the voltage of a stimulation pulse applied on the conductor(s), and selectively control by this voltage the closing of the active switch for a duration at least equal to the duration of detected stimulation pulse.

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: Systems, methods, and devices for activating an implantable medical device from a low-power sleep state are provided. One method includes receiving a wake-up signal at a receiver device from a transmitter device. The wake-up signal includes a series of pulses having a pulse pattern encoding a predetermined wake-up code. The wake-up signal is transmitted via intracorporeal communication of electrical pulses conducted by interstitial tissues of a patient's body. The method further includes extracting the wake-up code from the wake-up signal and determining whether the wake-up code corresponds to a stored wake-up value. The method further includes, in response to determining that the predetermined wake-up code corresponds to the stored wake-up value, switching at least one active circuit element of the receiver device from a lower-power sleep state into a higher-power operational state.

Abstract: An implantable line having an elongated line body, a function conductor extending in the longitudinal direction of the line body, acting to implement a medical function of the line, whereby in addition to the function conductor, a field decoupling conductor which extends over at least a section of the length of the line body essentially parallel to the function conductor is provided, thereby reducing the coupling of the function conductor to an external field.

Abstract: A single-chamber implantable device for detecting a patient's atrial activity using a monobody lead is disclosed. The monobody lead (10) includes a ventricular coil (16), a supraventricular coil (18), a distal electrode (14) forming three electrodes for detecting depolarization signals. A generator (12) of the implantable device collects a first unipolar signal (20) between the ventricular coil and the generator housing and a second unipolar signal (22) between the supraventricular coil and the generator housing. An independent component analysis is performed to the detected depolarization signals to determine an estimated atrial activity signal from the first and second unipolar signals.

Abstract: Devices and methods for providing pacing in multiple modes are provided. One device operates in a dual chamber (DDD or biventricular) mode and in a pacing mode favoring the spontaneous atrioventricular conduction such as an AAI mode (10) with a ventricular sensing or a mode with hysteresis of the atrioventricular delay. The device controls (10-18) the conditional switching from one mode to the other. The device comprises a hemodynamic sensor, including an endocardial acceleration sensor, derives a hemodynamic index representative of the hemodynamic tolerance of the patient to the spontaneous atrioventricular conduction. The device controls inhibiting or (20) forcing the conditional switching of the device to the DDD (or biventricular) mode according to the evolution of the hemodynamic index.

Abstract: A lead for an implantable cardiac prosthesis, with protection against the thermal effects of MRI fields by terminating the lead head (10) with an electrically insulating tubular outer housing (28) and an anchoring mechanism. The tubular housing (28) carries an electrically isolated thermally conductive solid part in the outer region of its distal end forming a heat sink. The heat sink thermally conductive material is for example titanium, associated with an electrically insulating coating such as a diamond deposition. The anchor may be a projecting helical anchoring screw (20), axially extending the tubular housing, which is an electrically conductive active screw on at least one end portion.

Abstract: Apparatus and methods for communicating between an apparatus, such as a medical device, and a remote device are provided. One method includes determining a first indicator representative of a long-term availability for each of a plurality of channels for communication between a medical device and a remote device. The method further includes receiving a communication request from the remote device and, in response to the communication request, determining a second indicator representative of a short-term availability for each of the plurality of channels. The method further includes selecting a communication channel from the plurality of channels based on the first and second indicators.

Abstract: A plug includes a pin having an axial contact at its opposite end with a mounting rod connected to a center conductor. At the interface between the pin and the inner wall of the plug body, a support sleeve mounted on the shaft and bearing axially against a collar formed on said rod is provided. Axially, a locking ring is secured to the shaft so that the support sleeve is clamped between the collar of the rod and the locking ring, if necessary, leaving a degree of freedom of rotation between the sleeve and the pin. Radially, the outer surface of the sleeve comes into direct contact with the inner wall of the bore of the plug body, to which it is directly secured. The direct attachment of the sleeve to the plug body may be obtained by a snap-in connection with notches cooperating with a counterpart groove.

Abstract: A kit for penetrating the cardiac septum and for implanting a transeptal lead, including a lead for the detection/stimulation of a left heart cavity. This kit includes a screw lead (16) and a radio-frequency puncture generator (32). The lead includes: a lead body with a deformable sheath (18); a proximal end having an electrical connector (20) for coupling to an implanted medical device housing; a distal end having a lead head (22) with an electrode including a projecting conductive helical screw (24) for penetrating into the septum (10) due to a screw movement applied from the proximal end of the lead, and a conductor (26) connecting the electrode to the electrical connector, the electrode including the screw.

Abstract: A system and method for implantation of an autonomous intracardiac capsule. The autonomous capsule includes a cylindrical body with an anchoring screw for penetrating a tissue wall, and at least one coupling finger radially projecting outwards. An implantation accessory includes a lead body and a helical guide, for guiding and driving by rotation the capsule. This helical guide is integral with the lead body, and its inner diameter is sufficient to contain that cylindrical body of the capsule therein. The helix direction of the helical guide is opposite to that of the anchoring screw such that continued rotational motion imparted on the lead body drives the anchoring screw into the target tissue and then emerges the capsule from the helical guide. The helical guide is resiliently compressible in axial direction, and its helix pitch is increased in the free distal end portion.