Abstract: An active implantable medical device, such as a pacemaker, defibrillator, cardiovertor and/or a multisite device, having an improved detection of late atrial extrasystoles. The device detects atrial events (EvtA); applies a first window forming a relative atrial refractory period (DARRP) for discriminating (filtering) atrial extrasystoles of an early or average prematurity, and reacts to a variation of the sinusal atrial rate by certain control algorithms. It also applies the detected atrial events to a second window (DLE), distinct from the first window and of longer duration, for the discrimination of the atrial extrasystoles having a low prematurity, called late extrasystoles. The duration of the second window is a variable duration, defined as a fraction of the current average atrial interval (AAI). Further, the second window is used to inhibit temporarily any reaction to a variation of the sinusal atrial rate, in the event of detection of an atrial event inside the second window.

Abstract: An active implantable medical device, in particular a pacemaker, cardioverter, defibrillator and/or a multisite device having circuits for measuring a trans-septal bio-impedance. This device is used with electrodes placed in a plurality of distinct respective sites comprising at least one left ventricular site and one right atrial site. These electrodes are connected to a collection circuit for collecting cardiac signals, in particular to detect a potential of depolarization, and to a stimulation circuit, to apply stimulation pulses to at least some of the aforementioned sites. The device evaluates the cardiac flow by obtaining an intracardiac measurement of the bio-impedance, more particularly measuring the trans-septum impedance bio-between the left ventricle and the right atrium, by injection of a current (16) between an atrial site (RA−) and a ventricular site (LV−), and collection of a differential potential (20) between an atrial site (RA+) and a ventricular site (LV−).

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator, cardioverter, or multisite device, having an improved cycle to cycle adjustment of the stimulation amplitude. The device stimulates the ventricle, adjusts the stimulation amplitude, periodically evaluates a capture threshold and defines a safety amplitude (Vs), and determines the detection or the loss of a capture on each cardiac cycle after stimulation with a given stimulation amplitude (V). Preferably, the device defines a capture amplitude (Vc) that is higher or equal to the capture threshold, but lower than the safety amplitude.

Abstract: A coronary probe for stimulation of the heart having a sophisticated retention structure. The probe is intended to be implanted in a vein of the coronary network for the stimulation of a left cavity of the heart by an active implantable medical device. It includes a flexible hollow sheath (10) including an internal conductor, an intermediate element (12) with a cylindrical body (24) bearing retention structure, and an end forming a probe-head (14) that is equipped with at least one stimulation electrode (20). The retention structure includes at least one relief (28) formed on the cylindrical body (24) and presenting, as seen from the end, an overall circular contour so as to have locally an increased diameter compared to the diameter of the cylindrical body. This contour is eccentric compared to the axis (D) of cylindrical body.

Abstract: An active implantable medical device such as a pacemaker, defibrillator or cardioverter, able to detect a fusion situation for improving a capture threshold determination. This device is able to deliver to the patient's heart stimulation pulses presenting a predetermined amplitude and a duration, and adjusting the amplitude of these pulses. The adjustment involves calibrating the pulse amplitude, and delivering a stimulation pulse at null or at a primarily null voltage, and measuring automatically the ventricular capture threshold, including detecting the presence or absence of a capture consecutive to a stimulation. The fusion situation is monitored and, in the event of detected fusion situation, used to invalidate the adjustment of the stimulation pulse amplitude. This operates by delivering a stimulation pulse at null or primarily null voltage, and determining the presence of a fusion situation in the event of a detection of a capture in response to a stimulation at null or at primarily null voltage.

Abstract: A single-path lead for an active implantable medical device of the implantable defibrillator/cardioverter type. The lead includes a lead body (10) carrying first (14) and second (16) atrial electrodes for sensing an atrial cardiac signal, first (18) and second (20) ventricular electrodes for sensing a ventricular cardiac signal, one (18) of these ventricular electrodes also being an electrode for use in the application of defibrillation or cardioversion energy (shock pulses), and a supra-ventricular electrode (12) for use in the application of the aforementioned shock energy for the defibrillation or cardioversion.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator and/or cardiovertor of the multisite type, capable of detecting an induced tachycardia. Such a device is to be coupled to electrodes placed in at least two cardiac sites of the same cardiac chamber type, e.g., at least two ventricular sites, right and left, at least two atrial sites, right and left, or at least two sites of the same cavity (atria or ventricular). The device has a cardiac signal collection circuit to detect a depolarization potential, and a stimulation circuit to apply stimulation pulses to at least certain of the aforesaid sites.

Abstract: A method and kit for the installation of a probe, implantable in the coronary sinus network for stimulation of a cardiac cavity. The kit includes: a) a guiding catheter (14), having an internal lumen open at its two extremities and able to receive the probe (10) along its length; and b) an extension (22) comprising at its distal extremity a connector (24) engaging a monodiameter connector (20) at the proximal extremity of the probe (10). The external diameter of the connector (24) is the external diameter of the remainder of the extension (22). The external surface of the extension (22) is a surface having a low coefficient of friction as compared to the interior surface of the lumen of the guiding-catheter (14), and the external diameter is smaller than the interior diameter of the lumen of the guiding-catheter, so as to allow the guiding catheter to slide over and along the entire length of the extension, without a concomitant axial displacement of the probe.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator and/or cardiovertor of the multisite type, having an improved resynchronized cardiac stimulation capability for the treatment of cardiac insufficiency in which the maximum stimulation frequency Fmax is gradually increased over time, starting from an initial value of F0 up to a target value of F1. Moreover, when the device shortens the atrio-ventricular delay as the instantaneous heart rate increases, the device also compares the instantaneous heart rate with a predetermined threshold, and allows the reduction of the atrio-ventricular delay only when the instantaneous heart rate is below this predetermined threshold, and gradually increases the atrio-ventricular delay as the instantaneous heart rate increases above the threshold.

Abstract: Measuring a trans-valvular bio-impedance in an active implantable medical device, in particular, a pacemaker, a defibrillator and/or a cardioverter and/or a multisite device in which electrodes are placed in at least one ventricular site and one atrial site and are connected to at least one circuit for the collection (detection) of cardiac signals, to detect a depolarization potential. The electrodes also are connected to a stimulation circuit to deliver stimulation pulses to at least some of the sites. The trans-valvular bio-impedance is measured by injecting a current between an atrial site and a ventricular site, and collecting a potential differential between an atrial site and a ventricular site. The measurement configuration is a tripolar configuration, with one site common to the injection and the collection, one site dedicated for the injection and one site dedicated for the collection.

Abstract: A process for sampling a cardiac parameter, in particular an intracardiac impedance, in an active implantable medical device such as a pacemaker, defibrillator, cardioverter and/or multisite device. The process includes carrying out in a repeated manner over a plurality of successive cardiac cycles (CYCLE 1 . . . CYCLE 8), the steps of detecting a moment (E) at which a ventricular event occurred, and then sampling the aforesaid signal during each cardiac cycle with a constant sampling step and a predetermined temporal shift (&Dgr;t1 . . . &Dgr;t8) between the detected ventricular event and the first sample in each cycle, this temporal shift being a progressive variable shift from one cycle to the following cycle.

Abstract: A connector system for an active implantable medical device including a generator and a connector head (10) equipped with a plurality of parallel axial cavities (12) receiving respective probe connectors (14), and a reversible means for mechanical tightening of each probe connector in its cavity. The tightening can be obtained by retractable elements (32) actuated simultaneously by a common element (36, 38, 40) movable between two positions, one locked and the other unlocked. The retractable elements project radially inside each respective cavity when the common element is in a locked position to exert a radial contact pressure on each probe connector insert therein, preferably on electrically insulating areas (20, 22) of the probe connectors. The retractable elements (32) are preferably carried by a common barrel (28) movable in rotation around a central axis of the connector head.

Abstract: A dismountable connector head for an active implantable medical device such as a pacemaker, defibrillator, and/or cardioverter. The device includes a case (12) comprising on one of its faces a series of emerging insulating traverse (16) structures bearing conducting feed-through leads (14), connected to the internal circuits of the case, and a connector head (10) made of an insulating rigid material, able to receive the terminals of electrical contact. A mechanical connection component (24) is used to solidarize the case with the connector head. The connection component is a removable component able to allow the separation (dismounting) of the connector head from the case after solidarisation of the two parts. The connection component can in particular be an elastically deformable clamp (24), cooperating by two opposed ends with a peripheral groove in the insulating traverses (16) bearing the conducting feed-through leads (14), or a pin similarly engaging a groove in the insulating traverse.

Abstract: An active implantable medical device for electrostimulation in response to a determined sleep apnea syndrome, particularly a pacemaker. This device measures the respiratory activity of the patient, using for example, a minute ventilation sensor and/or a blood oxygen saturation sensor, and analyzes the sensor signal, to determine occurrence of an apnea according to the signal delivered by the sensor. The device also delivers an increase cardiiac pacing rate in the event of detection of apnea. The device also can deliver a neurological and/or cardiac stimulation so as to apply selectively to the patient an electric stimulus. The device also determines the patients's state of activity, according to predetermined criteria, such that the increased pacing rate is provided only during a sleep phase and otherwise inhibited.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator and/or cardiovertor of the multisite type providing resynchronization of the ventricles electrodes are placed in at least two sites, right and left, and are connected to a circuit for the collection of cardiac signals, to detect a depolarization potential. Electrodes also are connected to a stimulation circuit, to apply stimulation pulses to at least some of the sites. The device provides resynchronization of the ventricular contraction, by establishing a delay between the times of application of the respective stimulation pulses on the right ventricle (RV) and left ventricle (LV), determining a parameter (z) representative of the degree of synchronization between ventricles, and varying the delay in the direction of the improvement of the aforesaid representative parameter. The parameter is a bio-impedance measurement.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator or cardioveter of the multisite type, including a circuit for measuring intercardiac impedance. Electrodes are placed in at least one ventricular site and one atrial site, and are connected to a circuit for the collection of cardiac signals, to detect a depolarization potential, as well as to a stimulation circuit, to apply stimulation pluses to at least some of the aforementioned sites. The measurement of a trans-pulmonary bio-impedance is obtained by injecting a current from an injection circuit (16) between the case (18) of the device and a first atrial (RA−) (or ventricular) site, and measuring a differential potential (20) between the case (18) and a point of measurement located in a second atrial (RA+) (or ventricular) site using a collection circuit.

Abstract: An interconnection structure including an interconnection artery ensuring the parallel transfer, on a group of conductors, of information to be exchanged, configured in at least one ring (50; 60; 70) on which information circulates in a closed loop and in a one-way direction. The artery has a plurality of coupling points to the addressable elements of the microcomputer. Some of the points of coupling (10, 20, 30) include a register associated with the corresponding addressable element with the microcomputer, and others include a gateway (G1, G2. . . . GN) towards, and from, another ring of a lower order, on which lower order ring information also circulates in a closed loop and in a one-way direction. This results in a structure of plurality of hierarchised rings. The interconnection structure is particularly useful for battery operated processor controlled devices, such as active implantable medical devices, pacemakers, defibrillators and the like.

Abstract: An active implantable medical device, in particular a pacemaker, defibrillator and/or cardiovertor, able to identify and eliminate the artifacts of the detection of cardiac events. This device detects spontaneous events in a ventricular and/or atrial cavity cardiac; measures the intervals separating the successive detected events collected by the detection circuits; analyzes the cardiac rate of heartbeat, according to the measured values of intervals; and eliminates double detections of the same cardiac event, namely when an event detected is followed of an artifact likely to be also detected. The elimination of double detections is performed by seeking to identify an alternation of short intervals (t1, t3, t5, . . . ) and long intervals (t2, t4, t6, . . . ) in the successive measured intervals (t1, t2, t3, t4, t5, t6, . . . ) separating a series of consecutive events (R1, R′1, R2, R′2, R3, R′3, . . .

Abstract: In the “multisite” pacing device of the present invention, electrodes are placed in a plurality of respective distinct sites including at least one ventricular site (22, 24). These electrodes are connected to a circuit for cardiac signal collection to detect a depolarization potential at the corresponding site, as well as to a stimulation circuit (30) to apply necessary stimulation impulses at this same site. The stimulation circuit, common to the electrodes, is selectively and programmably connected to and one and/or the other of the right and/or left electrodes of the concerned cavity. The stimulation circuit can particularly be a circuit programmable in either a bipolar or monopolar stimulation mode, where the selection means applies the stimulation impulse to one of the electrodes when the circuit is programmed in monopolar mode, and to the two electrodes when the circuit is programmed in bipolar mode.

Abstract: A circuit for detection of the presence of a permanent magnet in the vicinity of an active implantable medical device, in particular a pacemaker, a defibrillator, a cardioverter and/or a multisite device. This circuit includes a coil (12), able to respond to the presence of the magnet (16) so as to present a decreased value of its inductance, a resonant LC circuit (10) including the aforementioned coil, a generator (18) for pulse excitation of the resonant circuit; a circuit to analyze the pulse response of the resonant circuit, and a discriminating circuit, able to evaluate the value of the coil inductance from the analyzed pulse response and, correlatively, to determine therefrom the presence or the absence of the magnet.