Abstract: A circuit for controlled commutation of multiplexed electrodes, for an active implantable medical device. This circuit is located in a lead equipped with multiplexed sensing/pacing electrodes. This circuit decodes a signal generated by a generator, commanding a series of switches, which ensures selective coupling of the various electrodes to the proximal and distal terminals of the generator. This signal is a modulated signal comprising a coded series of logic pulses defining a particular configuration for coupling the lead electrodes to the proximal or distal terminal of the generator. The signal comprises a micropulse, that precedes the coded series of logic pulses and has an amplitude and duration lower than the amplitude and duration of each of the logic pulses. The detection of this micropulse activates, in response, all the circuit switches to an open position over a duration (PHASE 1) at least equal to the duration of reception of the coded series of logic pulses.

Abstract: An active implantable medical device for the treatment of heartbeat rate disorders including the detection, analysis and treatment of ventricular pauses. The device includes circuits for delivering ventricular stimulation, circuits for detecting a normal spontaneous ventricular cardiac activity; a circuit for controlling ventricular stimulation that is suitable to control the application of a stimulation in the absence of normal spontaneous ventricular activity; and the continuous recording of the current cardiac information, such as detected cardiac activity and/or of parameters representative of those events. It also includes an algorithm for the controlled inhibition of the ventricular stimulation such that ventricular pauses of a duration greater than a predetermined value (X) are detected, wherein the predetermined value evolves over time in a progressive manner, and the ventricular pauses occur during the periods of controlled inhibition of the ventricular stimulation.

Abstract: An active implantable medical device comprising circuits for right ventricular, left ventricular, right atrial and eventually left atrial detection, as well as circuits for right and left ventricular stimulation. The device can operate in mode of resynchronization of the ventricular contractions, with an adjustable delay of inter-ventricular stimulation. It includes moreover: circuits for atrial stimulation; circuits able to operate the device in AAI mode with right atrial stimulation and right ventricular detection; circuits for detection of ventricular capture, to determine the detection or the loss of capture after a right ventricular stimulation and a left ventricular stimulation; and of the circuits for mode switching, able to control a switching of mode, from the mode of resynchronization towards AAI mode, in response to the detection of a loss of capture after a right ventricular stimulation or a left ventricular stimulation.

Abstract: An active medical device that is able to detect and treat ventiliatory activity disorders during sleep. This device measures the patient's respiratory activity, delivers a signal of the ventiliatory activity of the patient, analyzes the ventiliatory activity signal, and detects the occurrence of hypopneas. The analysis includes calculating at regular intervals a sliding average of the signal of ventiliatory activity, comparing the values of the successive sliding averages thus calculated, and detecting an occurrence of an hypopnea when, for two successive sliding averages, the difference between the averages crosses a predetermined threshold of comparison. When the device is one that also delivers cardiac stimulation pulses, it is advantageously envisaged to modify an operating parameter, in particular the stimulation rate based on the detected hypopnea, to treat the hypopnea.

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 derivations 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 orthonormated 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: 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 derivations 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 orthonormated 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 implantable biocompatible component (10) integrating an active element of the type of a sensor for the measurement of a physiologic parameter, a micro-electromechanical system and an integrated electronic circuit. This component (10) has a substrate (12) and a lid (22) in silicon or quartz. The substrate (12) integrates the active element (14) and biocompatible metallic pads (16), electrically connected to the active element. The lid (22) encompasses and peripherally closes the substrate in a hermetic manner, level with the face integrating the active element. This component is void of metallic case for insulation between the active element and outside environment, and of insulative feedthrough for electrical connection to the active element. The substrate and lid can be directly welded to each other through their faces in vis-à-vis, or by interpositioning a sealing ring made of a biocompatible material.

Abstract: A device including circuits able to control the switching of a AAI mode in a DDD mode, and conversely the return of DDD mode to AAI mode, according to predetermined criteria of detection of atrio-ventricular block (AVB) of the first, second, or third degree and of ventricular pause. The device includes moreover circuits for detecting state, able to diagnose at least a specific temporary state of the patient, in particular a state of effort or sleep, and the circuits for mode switching operate in response to these circuits for detecting state to modify selectively, for the length of time when the aforementioned state is diagnosed, the criteria of switching from AAI mode towards DDD mode and/or the criteria of return to AAI mode, and/or the criteria of final commutation in DDD mode.

Abstract: A device for analyzing a physiological signal, such as an electrocardiogram or electrogram, that was previously collected, filtered, sampled and digitized. The device memorizes the digitized signal and analyzes it by decomposing the signal into a plurality of N parameterized bump functions, where each bump function is a continuous function defined by three successive intervals, respectively, a first monotonic parameterized function, an affine function, and a second monotonic parameterized function, with one of the monotonic parameterized functions being increasing and the other decreasing. The parameterized functions are preferably half-Gaussian functions, and the affine function preferably has a null slope. Each N bump function is classified by recognizing at least one parameter characteristic of each wave, and allotting a standardized label, selected among a plurality of predetermined labels, according to one or to more of the characteristic parameters thus recognized.

Abstract: An active implantable medical device, such as a double chamber pacemaker or defibrillator or cardiovertor, having an improved adjustment of atrial sensitivity and of atrial stimulation energy. This device includes control algorithms for suspecting a loss of atrial detection and/or atrial capture that operates by analysis of a sequence of detected stimulations and ventricular and atrial detections.

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: RF telemetry for an active medical device such as active implant or programmer for such implant. The device includes at least one RF antenna (14), and at least one RF telemetry transmitter/receiver (44) with, for coupling to the antenna, an associated band rejection filter (54). The band rejection filter (54) comprises at least one volume acoustic wave BAW resonator (40) of the SMR type with insulation by Bragg acoustic reflector (42). The device can be a multi-band device comprising a plurality of RF transmitters/receivers (12, 44) operating in respective distinct bands of frequencies such as the 402˜405-MHz, 863˜870-MHz, 902˜928-MHz and 2.4-GHz bands or by UWB transmission.

Abstract: A system of connection of a probe terminal to a connection head of an implantable medical device. A connection terminal is assembled at the proximal end of a probe to be inserted in a cavity of a connector head of the housing of an implantable medical device. The connection terminal is covered on its external surface by a layer of anti-adhesion material, in particular a carbon film laid down by cathodic sputtering with a thickness less than 1 ?m. In the alternative, the layer can be applied on the interior wall of the cavity of the connector head.

Abstract: An active implantable medical device of the defibrillator, cardiovertor and/or antitachycardia pacemaker type having a high maximum frequency for antibradycardia stimulation. This device provides antibradycardia stimulation at a stimulation frequency that has a programmed maximum stimulation frequency. For a detected rate exceeding a given frequency threshold, the device analyzes the cardiac activity to discriminate a ventricular tachycardia or fibrillation to command in consequence an appropriate antitachycardia therapy. The maximum stimulation frequency for antibradycardia is higher than the given frequency threshold for the antitachycardia analysis, and the cardiac rhythm is analyzed to detect a particular succession of events that are likely to reveal the presence or the appearance of a ventricular tachycardia during such high antibradycardia stimulation.

Abstract: A process for managing medical data in an active implantable medical device such as a pacemaker, defibrillator, cardiometer or multisite device for use of the medical data by a specialized follow-up practitioner such as a cardiologist. The process is characterized by reading by telemetry the memory data (12) of the device (10) in a patient by use of a programmer (14), memorizing in a database within the programmer the raw medical data thus read, the database having a memory field (24) containing an identifier of the patient (26), an address (28) of the follow-up practitioner such as a cardiologist or a regular practitioner ensuring the medical follow-up of the patient, as well as the aforementioned raw medical data (30), transmitting by a telematic way (36) to that follow-up practitioner, at the corresponding address, the medical data relating to the identified patient, and collecting, treating and presenting to the follow-up practitioner the medical data thus transmitted.

Abstract: Detection of an evoked post-stimulation potential, in particular atrial potentials, in an active implantable medical device such as a cardiac pacemaker, a defibrillator, a cardioveter, or a multisite device. This device applies a stimulation pulse (40), then shorts-circuit for a discharge period (42, OCD) the output circuit, which includes discharging a connection capacitor, the self-impedance of the probe, and the impedance of the interface heart-electrode. A detection circuit includes an amplifier and a blanking circuit to temporarily uncouple the input terminal from the amplifier.

Abstract: A modular electric terminal connector, in particular for a monobody defibrillation probe. This terminal includes a stacking of elementary cylindrical parts, alternatively conducting and insulating, each of which includes a central cavity receiving the sheath of a cable comprising several connection wires. An axial pin, placed on a casing at the free extremity of stacking, is connected to a respective connection wire to form an axial contact of the terminal. Rods passing through homologous borings formed in each part ensure axial and angular alignment of the various parts of stacking. The unit is solidarized by injection of an adhesive under pressure. Suitable openings make it possible to connect by laser welding the conducting elementary parts to the wires located in the sheath to form the annular contacts of the terminal.

Abstract: An active implantable medical device for cardiac rhythm management, such as a pacemaker, defibrillator, and/or cardioverter, having an improved DDD/AAI operating mode that automatically switches between operating in an AAI and a DDD pacing mode for cardiac rhythm management. This device includes atrial and ventricular detection and stimulation circuits. It can function in a DDD pacing mode or an AAI pacing mode with ventricular detection.

Abstract: An active implantable medical device with biventricular pacing and automatic optimization of pacing configuration. The device collects and analyzes an endocardial acceleration signal (EA), and searches for an optimal pacing configuration based upon a performance index derived from at least one value relating to one and/or the other of the two endocardial acceleration peaks (PEA 1, PEA 11) over a given heart cycle. Optimization search operates through a scanning of a parameter, e.g., atrio-ventricular delay, and calculation of the surface area underneath the characteristic of the peak amplitude as a function of the scanned parameter (atrioventricular delay).

Abstract: An active medical device equipped with a memory for the storage of medical data such as Holter data and instructions for controlling a microprocessor. This device comprises a micro-processor operating (14) on N bits, and a memory organized in words of 2N bits, with a first sector (22) storing a control software for the microprocessor, and a second sector (24) storing of the elementary medical data of N bits. Each word of the first sector includes N bits of operating code and n bits of error detection and correction code, with 1?n?N. An interfacing circuit (18) allows, according to commands delivered by the microprocessor, to read in parallel N+n bits of a word from the first sector, or to read or to write N bits of low weight of a word of the second sector, or to read or write N bits of high weight of a word of the second sector.