Abstract: An active implantable medical device with RF telemetry comprising subcutaneous ECG electrodes. The case (12) of the device comprises electrodes (20, 22, 24, 26) for collecting subcutaneous ECG signals coming into contact with the patient's tissues surrounding the case after implantation, as well as an RF telemetry antenna (30). These ECG electrodes are surface electrodes and the RF antenna is a surface antenna. The case (12) presents a significantly planar face (16) for mounting the ECG electrodes in an arrangement where these electrodes are significantly coplanar and spaced apart with each other, and receiving the surface RF antenna. A platelet (18) mounted onto the case comprises an insulating substrate comprising on its free face, conductive deposits (20, 22, 24, 26, 30) forming the ECG electrodes and the RF antenna.

Abstract: An active implantable medical device including bidirectional communications between a generator and sensors or actuators located at the distal extremity of a lead. A lead (14) is connected at its proximal end to a generator (10) and has at the distal end electrodes (38, 42) able to come in contact with surrounding tissues. A two-wire connection (34, 36) connects these electrodes to the generator. The lead incorporates transducers (24, 26) of sensor or actuator type. The generator includes circuits for sending and receiving digital data (46,48,50,54,56) capable of producing instructions to one of the transducers and to receive and decode information from one of the transducers in response to a specific instruction produced by the generator. The transducer is able to receive, decode and carry out the aforementioned controls, as well as send data in response.

Abstract: Electrocardiologic device for assisted diagnosis, preferably for the diagnosis of Brugada syndrome or Early Repolarization syndrome. This device allows characterizing the ventricular repolarization wave of an ECG signal collected from a patient. Extracting out of the ECG signal, for each heart beat, an ST segment is constituted of a succession of samples of the ventricular repolarization wave, taken within a time window ([QON+80 ms, QON+140 ms]) of a predetermined duration spreading from a moment of window onset defined by a time offset applied to a predetermined temporal origin given by the moment (QON) of appearance of the QRS complex, whose time position is determined on the ECG signal for each heart beat. Quantizing computes an elevation index compared to a predetermined reference level (BL), and analyzing over a succession of heart beats the persistence and/or variation of this elevation index.

Abstract: The instrument includes a connector block (24) suitable for receiving a removable memory card (12), a printed circuit (20), a case including an opening (16) for insertion of the memory card, and contacts (48) for reprogramming the microcontroller (22). The reprogramming contacts (48) are disposed on the printed circuit (20) at a distance from terminals (26) for making contact with the memory card, in the space that the connector block (24) occupies on the printed circuit, and they are available from the inside volume of the connector block. The instrument is essentially lacking in any opening dedicated to accessing the reprogramming contacts, with access to these contacts being possible via the opening in the case and the inside volume of the connector block by inserting an insert (52) into the instrument instead of and replacing a memory card.

Abstract: This device collects and analyzes general data on the state of the patient, and collects continuously a monitored signal representative of a physiological function. It includes a memory with a first zone for the durable memorizing of these data, and analyzes in real time the monitored signal to detect there the occurrence of a particular event. The memory includes a second zone for the continuous memorizing of the monitored signal over a first period of time, the memorizing being started on detection of a particular event. The device can also collect context information representative of circumstances possibly related to the occurrence of the particular event. The memory then includes a third zone, for the conditional memorizing of this information on detection of an event, for a second period of time shorter than the first period.

Abstract: The reconstruction of a surface electrocardiogram based upon an endocardial electrogram. This method includes: (a) acquisition (10) of a plurality of endocardial electrogram signals (EGM) through a plurality of endocardial leads defined based upon endocardial electrodes; (b) calculation (12), by combining the endocardial electrogram (EGM) signals acquired at step (a), of the corresponding endocardial vectogram (VGM); (c) angular rescaling (14) of the orthonormalized mark of the endocardial vectogram (VGM) with that of the surface vectocardiogram (VCG); (d) estimation (16), based upon the endocardial vectogram (VGM) calculated at step (b), of a reconstructed surface vectocardiogram (VCGreconstructed), and (e) calculation (18) of the surface electrocardiogram (ECG) corresponding to said reconstructed surface vectocardiogram (VCGreconstructed).

Abstract: An active implantable medical device comprising circuits for measuring trans-thoracic impedance and delivering an impedance signal varying with respiratory activity of a patient. A signal representative of the respiratory activity of the patient is delivered starting from the impedance signal, and circuits for diagnosing respiratory disorder analyze variations of the respiratory signal on a plurality of successive cycles to detect there a profile of predetermined variation in relation to a given respiratory disorder. The device also includes circuits for automatically controlling respiratory cycles with artifacts, able to identify in the impedance signal a jump of static impedance, and/or to identify in a respiratory cycle or in a sequence of respiratory cycles a predetermined singularity representative of a cycle with artifact.

Abstract: The reconstruction of a surface electrocardiogram based upon an endocardial electrogram. This method includes: (a) acquisition (10) of a plurality of endocardial electrogram signals (EGM) through a plurality of endocardial leads defined based upon endocardial electrodes; (b) calculation (12), by combining the endocardial electrogram (EGM) signals acquired at step (a), of the corresponding endocardial vectogram (VGM); (c) angular resealing (14) of the orthonormalized mark of the endocardial vectogram (VGM) with that of the surface vectocardiogram (VCG); (d) estimation (16), based upon the endocardial vectogram (VGM) calculated at step (b), of a reconstructed surface vectocardiogram (VCGreconstructed), and (e) calculation (18) of the surface electrocardiogram (ECG) corresponding to said reconstructed surface vectocardiogram (VCGreconstructed).

Abstract: Detecting a lead fracture in an active implantable medical device for pacing, resynchronization and/or defibrillation of the heart. This device senses the heart rhythm through an endocardial lead comprising at least one endocardial electrode collecting the depolarization potentials, and detecting the myocardium contractions through an endocardial acceleration sensor. The device detects an incipient or total lead fracture by correlating the signals representative of successive ventricular and/or atrial depolarizations (P, R) with the signals representative of successive acceleration peaks (e.g., PEA I). In the case of a lack of correlation, a signal of suspicion of lead fracture is delivered, notably to generate an alarm signal through recording of markers in a memory of the device readable by an external programmer, RF transmission and/or production of an audible signal.

Abstract: A tool for cutting or slitting the tubular sheath of a guide-catheter in the presence of a lead placed in this sheath. The tool (10) has a flattened, substantially planar blade holder body (12) with a cutting area (14) and a prehension area (16). The cutting area has a blade (18) and a tubular guide (22) receiving the lead for isolating it from the guide-catheter. The prehension area (16) has on a first side (30) an area for receiving the thumb and a lead holding pathway (68) spreading in the continuation of the tubular guide following an overall orientation forming an angle with this guide. The thumb reception area has a concave footprint (34) crossed through and through by the lead holding pathway (68), which spreads in the prehension area following an “S” shaped curve having a first curved area (74) and a second counter-curved area (76). The minimal distance between the blade (18) and the contour of the first footprint (34) is to the most equal to 15-20 mm.

Abstract: An active implantable medical device, such as a pacemaker, cardioverter and/ or defibrillator of AAI or AAI/DDD type, with detection of ventricular tachycardiae. This device senses spontaneous ventricular and atrial events; delivers atrial pacing pulses; and is able to apply, after delivery of an atrial pacing pulse, concurrently with sensing ventricular events, a refractory period (PR) and a safety window (FS) of predetermined durations; and determining the beginning of a spontaneous ventricular cycle in response to sensing of a ventricular event out of the safety window (R0, R1, R2, R3).

Abstract: An active implantable medical device of the AAI/DDD type, notably a cardiac pacemaker, including automatic mode adjustment at implantation. The device detects spontaneous atrial and ventricular events, and is able to pace the atrium and ventricle. The device can operate in an AAI mode with ventricular sensing, a DDD mode, and includes automatic mode commutation, able to schedule, as a function of predetermined criteria, commutation from AAI to DDD mode, and reversely from DDD to AAI. The device automatically detects an implantation and has its initial mode of operation adjusted upon detection of the implantation (10). The device temporarily operates (14) in an AAI mode with activation of the means for mode commutation, then analyzes (20) the atrio-ventricular conduction so as to detect whether a potential conduction disorder exists. In case of a potential conduction disorder existing (presence) (24), the device is then set to a DDD mode and the automatic mode commutation is inhibited.

Abstract: A probe including at its distal extremity a tubular flexible sheath core supporting at least a winding forming a shock electrode and connected to a electrical conductor of connection extending in a internal lumen of the sheath core. The sheath core extends axially without a solution of continuity in the area supporting the winding. In particular, the sheath core comprises cavities to receive and hold conducting inserts, of homologous size with cavities formed locally close to the ends of the winding, the insert being connected to the interior side to the electrical conductor, and on the external side to the corresponding extremity of winding. A longitudinal slit connects the two cavities and allows, by elastic deformation of the sheath core, the introduction into the cavities and in the internal lumen of the unit formed by the final extremity of the electrical conductor beforehand equipped with its two inserts.

Abstract: A process for mechanical assembly and electrical interconnection of the functional components of an active implantable medical device. A first step involves preparing an interconnection flex circuit (20) that is able to be electrically and mechanically linked to an electronic circuit module (14), a supply battery (12) and a series of feedthrough terminals (16) of the device, prior to being placed in a common case. The flex circuit has a series of pads (34) for linking to homologous metallizations (46) of the substrate. The mechanical assembling and electrical linking of these pads (34) to the metallizations (46) is performed without either the use of any activation flux or introduction of fusible brazing, and rather by applying an intermediate anisotropic conductive material (38) placed between the pads (34) and metallizations (46), followed by polymerizing this material. The applying and polymerizing are performed under controlled conditions of pressure, temperature and duration.

Abstract: A remote support system for programming active implantable medical devices such as cardiac pacemakers, defibrillators, cardioverters or multisite devices. A station is equipped with a programmer that is able to read, by telemetry, information stored in an implantable device, and transmit over a telephone line the information thus read, namely patient data and/or internal parameters for operating the programmer or programming parameters of the implant. A remote analysis station is configured to receive the information sent on the telephone line and display and/or analyze the transmitted information. The programmer includes an input to collect a voice signal and a multiplexor so that the data and/or parameters and the voice signal collected, are simultaneously delivered at the multiplexor output in real-time as a multiplexed signal that, in turn, is applied to a tele-transmission circuit (e.g., a modem).

Abstract: An active implantable medical device for diagnosis and/or therapy that is able to detect the occurrence of apnea and hypopnea. The detection of an occurrence of respiratory apneae or hypopneae is performed by collecting the patient's endocardial acceleration (EA), and determining at least one parameter, i.e., a peak acceleration, (PEA I, PEA II) that is a function of this collected endocardial acceleration. An apnea or hypopnea alert signal is then conditionally delivered as a function of the value taken by this (these) parameter(s).

Abstract: An active implantable medical device of AAI/DDD type, notably a cardiac pacemaker, with improved management of mode commutation schemes in the presence of ventricular events of an uncertain nature. The device is able to pace the ventricle and the atrium; sense ventricular events (R, r), apply a safety window following an atrial pacing pulse; perform mode commutation, conditionally triggering commutation of the device from AAI to DDD mode; and diagnose atrio-ventricular conduction disorders determining the appearance of an atrio-ventricular block based upon a sequence of atrial events (A) not followed, during an atrial escape interval, by the detection of the corresponding ventricular event (R) out of the safety window.

Abstract: An active implantable medical device, preferably a device for pacing, resynchronization, defibrillation and/or cardioversion of a patient, that includes functionality that assists in the diagnosis of the patient's clinical status. This devices comprises circuits (10, 12) for measuring one physiologic parameter, preferably minute ventilation (VE), and circuits (14, 16) for measuring a physical parameter, preferably acceleration (G), control logic (18) for discriminating between activity and rest phases of the patient, and analysis circuits (20-28), to process and combine these signals and memorize (store in memory) the obtained results in the form of a data history. The analysis will establish characteristics providing, for successive dates, representative values, for a given period of time, of the physical signal and physiologic signal during activity phases of the patient, and/or of the physiologic signal during rest phases.

Abstract: An active implantable medical device, notably for pacing, resynchronization, defibrillation and/or cardioversion of the heart, or for diagnosis of a patient's condition, able to produce a predictive alert in response to a detected degradation of the patient's clinical status. The device measures and analyses (56) a parameter representative of the patient's metabolic needs, such as minute ventilation (MV), and a physical activity parameter, such as acceleration (G). It further diagnoses heart failure by evaluating an index of the patient's clinical status through applying a set of status criteria (S1, S2). It further measures and analyzes (56) a hemodynamic parameter such as endocardial acceleration (PEA) or intracardiac impedance, representative of the patient's myocardium contractility. An index of cardiac contractility is created and evaluated through applying a set of contractility criteria (S?1, S?2).

Abstract: An active implantable medical device having an RF telemetry circuit. The device is in particular a stimulation, resynchronization, defibrillation and/or cardioversion device. It includes a principal circuit, an RF telemetry auxiliary circuit and a supply battery for the principal and auxiliary circuits. It is envisaged to have between the supply battery and the auxiliary circuit a regulating circuit including an accumulator of electric power coupled with the auxiliary circuit to deliver a current ready to feed the auxiliary circuit, and a load circuit coupled with the supply battery to maintain the accumulator on a predetermined level of load.