Abstract: An implantable medical device that measures respiration parameters based on transthoracic impedance signals, and converts transthoracic impedance signals into a time series of digital values which is filtered with morphological operators to separate the signal into a respiratory component and a cardiac component. Metrics are generated based on the filtered impedance values such as respiratory rate, I/E ratio, tidal volume and minute ventilation.

Abstract: The invention relates to a system and a method for the remote programming of a programmable personal medical device (10, 10?), in particular an implantable medical device such as a cardiac pacemaker, defibrillator, or the like, selecting (61) of a personal medical device, compiling (63) of a programming instruction (50) by accepting inputs of a user, and checking (63) the inputs for plausibility and compatibility with the personal medical device in a programming device (20), transmitting (65) the programming instruction to a patient intermediary device (30) tuned to the personal medical device via at least one indirect connection, receiving (67) of the programming instruction by the patient intermediary device, and transmitting of the programming instruction to the personal medical device, and accepting (69) of the programming instruction by a programmable controller of the personal medical device being provided.

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: A system for the endocardial stimulation/defibrillation of the left ventricle. This system includes a generator (60) and an endocardial lead. The lead includes a lead body (26) whose distal end (30) extends into the right ventricle (14) and is provided with a mechanism to anchor (32) the distal end to the interventricular septum (20). The lead body carries on it a stimulating and/or defibrillation electrode (38) (64, 66). A microcable (42) extends into the lead body and beyond, with an intermediate portion (56) crossing from one side of the interventricular septum (20) to the other, and an active free portion (58) that emerges in the left ventricle (16). The microcable is coupled to the generator, to produce an electric field (62) between, on one hand, the stimulation electrode (38) or defibrillation electrode (64, 66) of the lead body and, on the other hand, a bare region of the active free portion (58) of microcable (42).

Abstract: The invention comprises a system and a method for secure remote programming of an implant. For this purpose, a TAN list is generated on the part of the programming device and both stored in the implant (10) and also provided to a physician. The TAN list is preferably indexed and the implant predefines the index of a TAN in each case, which a physician must input to have a programming instruction executed by the implant.

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: An active medical implant, in particular a medical electronic device having a power supply which has a mechanical vibrator or rotor which is induced to vibrate and/or rotate by movements of the patient wearing the implant and/or external excitation and is energetically connected to an electronic consumer and/or an energy storage mechanism, such that a portion of the kinetic energy generated by the vibration and/or rotation is input into the consumer and/or energy storage mechanism.

Abstract: Forming a connector head for a generator of an active implantable medical device by providing a pin (20) having alternating smooth sections (21) for receiving an electrical contact (210) and a profiled section (22); disposing the electrical contacts on the smooth sections; injecting into a first mold a flexibly resilient material around the profiled sections of the pin to produce isolation elements between the electrical contacts; injecting in a second mold a rigid material around the pin to form the connector head with the electrical contacts and isolation elements embedded therein; and withdrawing the pin from the cavity of the connector head thus formed. The material provides precise axial and radial positioning of the different elements, and good electrical insulation.

Abstract: The invention refers to a monitoring device for monitoring and analyzing physiological signals. The monitoring device comprises a transthoracic impedance measurement unit and an evaluation unit connected to the transthoracic impedance measurement unit. The transthoracic impedance measurement unit is adapted to conduct a transthoracic impedance measurement and to generate a transthoracic impedance signal representing a measured transthoracic impedance at consecutive points in time. The evaluation unit being configured to process the transthoracic impedance signal received from the transthoracic impedance measurement unit and to thus generate a respiration signal and to generate therefrom an evaluation signal reflecting at least a diurnal pattern of the respiration rate.

Abstract: Improving the signal-to-noise ratio of electrocardiogram (ECG) measurements facilitates cardiac beat detection in a human or animal patient. ECG signals measured either on the surface of the skin or subcutaneously from pairs of leads may be combined to calculate a differential signal. The measured signal may also be averaged to produce a second estimate. A point-by-point product of the differential signal and the averaged signal is generated if the sample pair has the same polarity. The product signals feature enhanced signal components and reduced noise components, thus improving the signal-to-noise ratio of the to respective input channels. Product signals are then subjected to peak detection through a conventional auto-sensing approach. Preliminary event detection results from the conditional product signals may then be aggregated, and final sense markers for ECG beat detection may be generated by means of a voting algorithm.

Abstract: A cardiac pacemaker control system constituted of: a means for receiving input from a hemodynamic sensor; an adaptive control system in communication with the means for receiving input from the hemodynamic sensor; and an interface arranged to provide cardiac stimulation responsive to the adaptive control system; the adaptive control system comprising a learning module operative to converge to patient specific cardiac pacing stimulation timing using a machine learning scheme in cooperation with a probabilistic replacement scheme, the probabilistic replacement scheme arranged to replace inputs from the hemodynamic sensor with online calculated values.

Abstract: An active implantable medical device for cardiac resynchronization therapy with effort based rate-responsive pacing is described. The device calculates a rate-responsive stimulation frequency based on output signal of an effort sensor between a base frequency (fbase) and a maximum frequency (fmax). The device determines a target stimulation frequency based on the difference between a first frequency and the maximum frequency (fmax). The first frequency is the higher frequency of the base frequency (fbase) and the spontaneous frequency of the patient. The device calculates a stimulation frequency that has an immediate increase in the pacing rate from the higher of the initial value of the current stimulation frequency, or the spontaneous frequency to the target stimulation frequency, within a predetermined time, or a predetermined number of cardiac cycles. A plurality of consecutive effort zones (Z1-Z4) is defined over the extent of the dynamic range of the output signal of the effort sensor.

Abstract: An electrode for interventional purposes, such as a cardiac pacemaker, neurostimulation, or ICD electrode, comprises an elongate electrode body (6), at least one electrode pole (5) in the area of the distal end (4) of the electrode body (6) for delivering an intervention pulse, at least one supply line (7) running in the electrode body (6) to the at least one electrode pole (5), and an electrode sheath (8) for insulating the supply line (7). The first and/or second material is produced in such a way that it contains conductive particles embedded in a polymer matrix in a concentration which is greater than or equal to the percolation threshold.

Abstract: A multi-area pacing lead implantable in a target vein of the coronary network for stimulating a left cavity of the heart, comprising an electrically conductive microcable (12), an electrically insulating outer coating, and carrying at its distal end a free active portion containing a plurality of separate denuded areas forming a network of active stimulation electrodes (14, 16), intended to contact the wall of target veins. The active free portion has a proximal corrugated portion carrying a first set of electrodes (14), a distal corrugated portion carrying a second series of electrodes (16) and an intermediate portion (20) that traverses an anastomosis (22) connecting the ends of two veins (VA, VPL). Both sets of electrodes (14, 16) can thus be placed in two different veins, defining two remote stimulation areas.

Abstract: A wireless apparatus includes a cellular radio interface that is adapted to perform a data exchange by way of a wireless data network, a user identity module containing information for authorization of a user for use of wireless networks, and a control unit which controls establishment and implementation of the data exchange. A second control unit is included and adapted to limit, in respect of the duration of its effect, a rejection of the user identity module expressed by the locally available wireless data networks in logging on to the wireless data network by suitable control of the first control unit in the further course of the log-on process by bypassing communicated information about the rejection.

Abstract: Electrode device for active medical implants with an elongated electrode body (2) having a proximal end and a distal end (1), a tip contact pole (6) on the distal end (1), at least one ring contact pole (5) before the distal end (1), electrical supply leads (3, 4) to the tip and ring contact pole (6, 5), and a high-frequency filter (11) before the distal end (1), which has electrical contact to the tip contact pole (6) and is connected to the supply lead (4) thereof.

Abstract: The invention is directed to a heart stimulator for left-ventricular pacing comprising a left ventricular stimulation pulse generator connected or connectable to a single electrode lead for left ventricular stimulation having one or more electrodes for delivery of stimulation pulses to left ventricular myocardial heart tissue, said stimulation pulse generator being adapted to generate and deliver stimulation pulses of switchable polarity. The heart stimulator further comprises a control unit connected to the stimulation pulse generator for controlling the stimulation pulse generator and to trigger generation and delivery of stimulation pulses having a polarity controlled by said control unit, wherein the control unit is adapted to control said left ventricular stimulation pulse generator so as to deliver at least a pair of suprathreshold stimulation pulses of opposite polarity.

Abstract: Reconstruction of a surface electrocardiogram from far field signals extracted from an endocardial electrogram in an active medical device is disclosed. The device collects a ventricular EGM signal (EGMV) and an atrial EGM signal (EGMA), and extracts a ventricular far field signal component (FFV) and an atrial far field signal component (FFA). The ventricular and atrial far field signal components are combined to deliver as an output a reconstructed surface electrogram ECG signal (ECGj*). The ventricular and atrial far field signals are respectively extracted from the collected ventricular and atrial EGM signals (FFV, FFA). The reconstruction of the ECG is operated by ventricular (18) and atrial (16) far field signal estimator filters. According to one embodiment, the far field signal estimator filters are linear or nonlinear filters, receiving as input the far field signal components. An adder (20) adds the filtered signals and delivers as output the reconstructed ECG signal (ECGj*).

Abstract: An active implantable medical device for cardiac resynchronization with automatic and almost in real time optimization of the interventricular and atrio-ventricular delays is disclosed. The active implantable medical device includes a closed-loop for continuously controlling the atrio-ventricular delay AVD and the inter-ventricular delay VVD according to a hemodynamic signal delivered by a hemodynamic sensor. The closed-loop provides controlled modulation (38) and demodulation (42) the AVD, and modulation (48) and demodulation (52) the VVD, the modulation and demodulation being functionally interdependent (54, 56) by a sequence of alternating operation. A closed-loop regulator (36) for controlling the AVD receives as input an error signal (EAVD) delivered based on demodulating the AVD (42) and outputs an AVD signal. A closed-loop regulator (46) for controlling the VVD receives as input a signal error (EVVD) based on demodulating the DVV and outputs a VVD signal.

Abstract: Apparatus and method for detecting and filtering noise artifacts by analysis of a cardiac vectogram is disclosed. An active medical device collects electrical activity signals of a patient's heart over a series of cardiac cycles. At least two distinct temporal components (Vbip, Vuni) are obtained from at least two endocardial electrogram (EGM) signals that are collected concurrently on different respective channels from the same heart cavity.