Abstract: Determining the presence and type of a probe associated with an active implantatable medical device, in particular a cardiac pacemaker and devices having similar pacemaker functionality. This device includes circuits for producing monopolar or bipolar stimulation pulses, selectively with or without disconnection of a connection (S1, S2) to a reference potential, and a circuit for sensing a pulse signal produced by the variation of potential induced on one and/or the other of terminals (RING, TIP) and/or on the metallic case (CASE) in response to an application of stimulation pulses. The device operates to analyze a characteristic of the shape (28), in particular the pulse width, and to deliver an indicator representative of the presence or the absence of a probe. The device also can selectively modify at least one operating parameter of the device according to the delivered indicator.

Abstract: Apparatus for detecting atrial arrhythmias in the treatment of disorders of the heartbeat rate in active implantable medical devices of the pacemaker, cardioverter, defribillator and/or multisite type. This device includes conventional systems, circuits and control algorithm for detecting spontaneous and stimulated ventricular events (R, V) and atrial events (P, A), indicating the delivery of a ventricular and/or atrial event, and inhibiting the detection of atrial events after detection of a ventricular event throughout a post-ventricular atrial absolute refractory period (PVAARP). Detecting atrial events includes protecting against the detection of atrial signals that do not correspond to an atrial event that has actually occurred, in particular protecting against atrial detection of far-field signals caused by a ventricular event.

Abstract: An antenna system for collecting electric waves for the reception of magnetic induction signals emitted by an active implantable medical device. The system includes an antenna that comprises a reception coil (10) and a compensation coil (20), each of which preferably includes at least one series of turns (12, 22) wound around respective mandrels (16, 26) made out of a nonmagnetic material. The mandrels are positioned side by side with their respective axes (18, 28) spaced apart and parallel, and with their cross sections areas not superimposed. The cross section of the mandrel (26) of the compensation coil (20) is less than that of the mandrel (16) of the reception coil (10). The series of turns (22) of the compensation coil (20) can be split in a plurality of groups of turns (24) wound on the same mandrel (26), with an axial spacing and connected in series, preferably with the sections of winding and/or different numbers of turns being different.

Abstract: A set for installing an intracardiac lead equipped with a screw in a wall of the endocardium, particularly a stimulation or defibrillation lead. This set comprises a removable stylet (50), able to be introduced inside the sheath (12) of the lead-body and mobile in translation and rotation therein. The stylet has at its distal extremity a mechanism (56) for coupling in rotation to allow the rotation (28) of the lead-head (10). The stylet (50) includes: a central core (52, 71) carrying at its distal extremity the aforementioned coupling mechanism, and at its proximal extremity a handling body (32) for handling by the physician and a hollow tube (54) axially placed around the core.

Abstract: An active implantable medical device, such as a pacemaker, defibrillator and/or cardiovertor having an AAI and/or an AAI/DDD operating mode. This device detects atrial and ventricular events and stimulates the atrium, and calculates an atrial escape interval (AEI). The device defines a critical period preceding or following the end of the AEI and determines, in the event of detection of a ventricular extrasystole (VES), if the moment of occurrence of the VES is in the critical period. The device then recognizes a risk of inappropriate operation and/or false diagnosis related to the temporal proximity of the VES and end of the AEI. In such a case, the device modifies an operating parameter so as to eliminate this risk, for example, by resetting the counting of AEI (AEI*) on detection of the VES. The device can also inhibit a switching of AAI mode to a DDD mode in the event of risk of false diagnosis of atrio-ventricular block.

Abstract: Apparatus and technique for compensating the potential detected by amplifier circuits for sensing cardiac activity in an active implantable medical device, such as in a pacemaker, defibrillator, cardioverter and multisite device. This device includes circuits for delivering to a cardiac cavity stimulation pulses of predetermined voltage levels and pulse widths, and circuits for sensing cardiac activity comprising an amplifier of signals sensed by an intracardiac electrode, delivering at its output a value of measured potential (Pmeasured) consecutive with the application of a stimulation pulse (I). The device includes circuits for determining a response potential specific to that amplifier, independently of the presence or absence of a myocardial depolarization.

Abstract: An active implantable medical device of the defibrillation/cardioverter type able to detect a post-therapy sinusal tachycardia. This device includes circuits and logic able to detect ventricular and atrial activity; episodes of tachycardia and deliver a therapy for defibrillation and/or cardioversion, and/or antitachycardia stimulation. The detected tachycardia are classified, and there is selective control for the delivery of therapy according to the type of detected tachycardia classified. The device conducts further analysis of tachycardia after delivery of a shock therapy and is able to determine the presence of a post-therapy sinusal tachycardia, preferably by recognition of a stable ventricular rate, a 1:1 association of ventricular and atrial rates, a ventricular heart rate that is located in a range corresponding to a slow ventricular tachycardia. The device also is able to inhibit the delivery of a therapy in the presence of determined post-therapy sinusal tachycardia.

Abstract: A process for managing data collection for clinical protocols and investigations (registry) relating to the use of active implantable medical devices, such as pacemaker, cardiovertor, defibrillator and multisite devices.

Abstract: Detection of a discontinuity, a disconnection or loss of conductivity, of cables connected to a physiological signal recorder, in particular a Holter recorder of ECG signals by measuring an impedance of the line(s). To measure the impedance of the line comprising the connecting cable connecting an external electrode placed on a patient to a signal terminal (12) of the recorder (10), one generates a current impulse, applies this impulse to the line, measures the variation of voltage resulting on the terminal from the signal during the application duration of the current impulse, and determines the impedance of the line based upon the voltage variations thus measured. The current impulse is a biphasic impulse including two successive cycles of opposite polarities, the durations and the amplitudes of these two cycles being selected so as to define approximately equal respective loads and of contrary signs.

Abstract: A process for the presentation of data stored in an active implantable medical device to assist a practitioner in making a diagnosis.

Abstract: A circuit for delivering a back-up stimulation voltage in a cycle to cycle capture test for an active implantable medical device such as a pacemaker, defibrillator and/or cardiovertor or a multisite device having an enhanced circuit for delivering back-up stimulation pulses.

Abstract: An active implantable medical device of the multisite defibrillator/cardioverter type having a sophisticated management of ventricular tachycardias. This device delivers a one of a defibrillation and/or cardioversion and/or ventricular antitachycardia pacing (“ATP”) stimulation therapy mode, as desired and known in the art. The device senses the cardiac activity and detects in the sensed activity a disorder of the ventricular rhythm that is distinct from a ventricular fibrillation condition. The device also includes delivery of biventricular stimulation, connected to at least two ventricular sites, right and left, which is triggered on the detection of the aforesaid disorder of the ventricular rhythm prior to delivering the conventional ATP or shock therapy mode.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator, cardiovertor, or a multisite device including detection of a risks of a fusion situation. This device is of the double chamber type, and it detects atrial and ventricular events, provides atrial and ventricular stimulation, and delivers a ventricular stimulation pulse after expiration a programmed atrio-ventricular delay (AVD) following the detection of an atrial event (P, A), and in the absence of detection of a ventricular spontaneous event (R) within the AVD. A fusion situation is detected based on an analysis of a sequence of successive cardiac cycles for which the atrio-ventricular delay is modified from one cycle to the next (AVD, AVD+31, AVD+63).

Abstract: A process for the measurement of the complex impedance of a lead for an active implantable medical device, in particular a pacemaker, defibrillator and or cardiovertor. This process includes the steps of producing a stimulation pulse by the discharge on the lead (10) of a tank-capacitor (22) of the device (20), charged beforehand to a given voltage level; measuring the voltage variation (V(t)) at the terminals of the tank-capacitor during the discharge; and determining the lead impedance (Zs) from the voltage thus measured. The measurement stage includes sampling at least three successive values of the voltage at the terminals of the tank capacitor, and the determining stage includes the separate determination of the resistive (Rs) and/or capacitive (CH) components of the complex impedance of the lead from the aforesaid at least three sampled values of voltage thus obtained.

Abstract: A method for manufacturing a plurality of hybrid electronic circuits for active implantable medical devices and circuits made by the process.

Abstract: An active medical device have an improved diagnosis of a sleep apnea syndrome. This device measures the respiratory activity of the patient, determines a state of activity, this state being likely to take, according to satisfaction of predetermined criteria, a value representative of a state of sleep of the patient, and analyzes a detected signal corresponding to the respiratory activity to detect, when the aforementioned state is a state of sleep, the presence of respiratory pauses, and thereby to produce an indicating signal of sleep apnea in the event of the occurrence of a respiratory pause of duration longer than a first predetermined duration. The analysis also includes inhibiting the production of the aforesaid indicating signal, or a treatment to resolve an apnea, when the duration of the detected respiratory pause is longer than a second predetermined duration, typically of at least one minute.

Abstract: An active implantable medical device, in particular a defibrillator/cardioverter, with a sophisticated discrimination of atrial fibrillations. This device is able to deliver therapy for defibrillation, cardioversion, and/or ventricular and/or atrial antitachycardiac pacing stimulation; sense the ventricular and atrial activity; identify a suspicion of and confirm the presence of episodes of tachycardia in the activity thus sensed; analyze the stability of detected RR intervals and the stability of the associated PR intervals; and, in the event of a detection of stable RR intervals and unstable PR intervals, discriminate between atrial fibrillation with fast ventricular rhythm and atrial fibrillation with ventricular tachycardia, and to control delivery of a differentiated therapy according to one case or the other. A bi-tachycardia discrimination also can be made.

Abstract: An active medical device to diagnose a patient respiratory profile. This device is able to measure respiratory activity and deliver a signal (26) representative of the periodicity and amplitude of the successive respiratory cycles of the patient, in particular, a of minute ventilation (MV) signal. The device is able to analyze the aforementioned signal and discriminate between various types of respiratory profiles, in particular, to diagnose a respiratory profile of the Cheyne-Stokes type. This is achieved by detecting an alternation of respiratory cycles of hyperventilation (20) separated by periods of respiratory pause (22) or periods of hypoventilation or normal ventilation (24) and, in the latter case, to discriminate between periods of respiratory pause, corresponding to a profile of the Cheyne-Stokes (CSR) type, and periods of hypoventilation or normal ventilation, corresponding to a profile of the periodic breathing (PB) type.

Abstract: Apparatus and process for processing and memorizing in a differentiated form data relating to data recorded over a long time period, in particular in an active implantable medical device, more particularly, Holter functions. This process includes the steps of: a) memorizing in a first memory sector (10) a detailed representation of the data, e.g.

Abstract: An active medical device having an improved discrimination between an awake phase of a patient and a sleep phase of a patient. This device measures a physiological parameter of a patient, delivers a physiological signal with a slow time response variation, in particular a signal of minute-ventilation (signal MV), and detects whether the patient is in a phase of awakening or sleep. An average (VE) of the signal MV is calculated over a given number of respiratory cycle and compared with a predetermined threshold (Threshold MV), such that a first state of awakening is determined when the average is higher than the threshold, and a first state of sleep is determined in the contrary case. The device also measures patient activity (signal G), using a signal having a short response time.

Abstract: An accessory rack for storing a plurality of articles such as wearing apparel or clothing accessories including jewelry, scarfs, ties, belts, chains, handbags, beads and the like and which includes a plurality of generally C-shaped hooks which are suspended from a telescoping housing so as to provide upper and lower rows of horizontally oriented and spaced support bars upon which such articles may be selectively and securely supported.