Abstract: A lead for active implantable medical devices comprising a chip, notably for electrode multiplexing. The lead includes an insulating supporting tube interposed in a flexible elongated tube, with a central bore coaxial with the lumen of the lead. The supporting tube comprises on its surface at least one crossing conductive strip extending in the axial direction. A chip on a flexible substrate is disposed with a bent or curved conformation in a receptacle of the supporting tube isolated from the conductive strip. An electrode, e.g., for cardiac sensing/pacing, carried by the supporting tube is electrically connected to an outer conductive pad of the chip. The conductive strip is connected (i) at each end, face to face to a conductive connection, housed in the sheath, and (ii) in a central region, to an inner conductive pad of the chip.

Abstract: An energy harvester device for an autonomous intracorporeal leadless capsule comprises a surface formed on the outside of the body of the capsule that is deformable under the effect of pressure variations in the environment surrounding the capsule. A first capacitor electrode coupling to the deformable surface with the interposition of a damping element forming high-pass filter with respect to pressure variations in the surrounding medium, and a second capacitor electrode mounting on a support connected to the body. The movement of the deformable surface produces a modification of surfaces in vis-à-vis of the two electrodes and/or of the dielectric gap which separates them, with a variation of the capacity of said capacitor. The capacitor is preloaded when its capacity is maximum, and unloaded by transferring energy into storage circuit when this capacity decreases from a reduction in surfaces in vis-à-vis and/or of an increase of the dielectric gap.

Abstract: A pacing lead for a left cavity of the heart, implanted in the coronary system. The lead includes a lead body with a hollow sheath of deformable material, having a central lumen open at both ends, and at least one telescopic microcable of conductive material. The microcable slides along the length of the lead body and extends beyond the distal end thereof. The part emerging beyond the distal end is an active free part comprising a plurality of distinct bare areas, intended to come into contact with the wall of a target vein of the coronary system, so as to form a network of stimulation electrodes electrically connected together in parallel. The microcable further comprises, proximally, a connector to a generator of active implantable medical device such as a pacemaker or a resynchronizer.

Abstract: A intracorporeal medical capsule is shown and described. The capsule includes an elastically deformable base having an anchor at one end and coupled to a capsule body at the opposite end. An energy harvesting element is elastically coupled to a seismic mass within the capsule body. The elastically deformable base increases energy harvested at the energy harvesting element due to elastic movement of the capsule body in the presence of blood flow around the capsule body.

Abstract: A system and method for optimizing cardiac resynchronization therapy and visualizing cardiac pacing intervals. The system comprises at least one hemodynamic sensor; at least one electrode; a learning module; a micro controller; and at least one graphical interface for showing at least one of a PRV vs. PLV diagram and a responder curve.

Abstract: A device, for adaptive processing of an endocardial acceleration signal, continuously collects an endocardial acceleration EA signal and divides it into EA sub-signals, each over the duration of one cardiac cycle. The EA sub-signals are separated into the EA1 and EA2 components. A cross-correlation between the EA sub-signals of each component and a time calibration compared to a reference cycle, and a series of validation criteria is applied. The result is an average overall EA signal for a cycle. A change in the patient's condition or an occurrence of a predetermined event in the patient is detected (24) and, as a result there is dynamic adaptation of at least one of said validation criteria and/or at least one of the preprocessing parameters for calculating the EA signal average.

Abstract: An active implantable medical device for vagal stimulation with optimization of ventricular filling is disclosed. The device delivers stimulation pulses to the vagal nerve of the patient with an adjustable energy level. The device includes a hemodynamic sensor for measuring hemodynamic parameters of the patient's cardiac cycles and delivering a timing parameter representative of the ventricular filling time. The energy level of the vagal stimulation pulses is adjusted dynamically and repeatedly over several cardiac cycles. The energy level is varied during successive cardiac correlative changes in the filling time (FT1, FT2) are assessed, and the energy level is set to a level that maximizes the ventricular filling time.

Abstract: An RF telemetry receiver circuit for active implantable medical devices. The baseband binary signal (Db) is doubly modulated by a low frequency carrier (Fm) and by a high frequency carrier (Fc). The receiver circuit is a semi-passive non heterodyne circuit, devoid of a local oscillator and mixer. It comprises an antenna (104), a passive bandpass filter (108) centered on the high-frequency carrier (Fc), a passive envelope detector (120-126) and a digital demodulator (116). The envelope detector comprises a first diode circuit (120) of non-coherent detection, an active bandpass filter (122) centered on a frequency (2.Fm) twice the low frequency carrier and having a bandwidth (2.Db) twice the baseband bandwidth, and a second diode circuit (124) of non-coherent detection, outputting a baseband signal applied to the digital demodulation stage (116).

Abstract: An active medical device using non-linear filtering for the reconstruction of a surface electrocardiogram (ECG) from an endocardial electrogram (EGM) is disclosed. The device for the reconstruction of the surface ECG includes a plurality of inputs, receiving a corresponding plurality of EGM signals from endocardial or epicardial electrogram (x1[n], x2[n]), each collected on a respective EGM derivation of a plurality of EGM derivations, and at least one output delivering a reconstructed surface ECG electrocardiogram signal (y[n]), related to an ECG derivation, and a non-linear digital filter (12?, 12?, 14) with a transfer function that determines the reconstructed ECG signal based on said plurality of input EGM signals. The non-linear digital filter includes a Volterra filter type (12, 12?, 12?) whose transfer function includes a linear term (h1) and at least one quadratic (h2) and/or cubic (h3) term(s).

Abstract: A method of implanting a lead in the left heart cavity includes introducing the lead into the right heart cavity. The lead includes a lead body having a deformable sheath, a proximal end having an electrical connector, a distal end including a projecting helical screw electrode, and a conductor extending along the sheath, electrically connecting the electrical connector and the helical screw. The method further includes positioning the distal end of the lead to abut a septum wall between the right and left heart cavity. The electrical connector is connected to an RF puncture generator and RF energy is applied to the screw while providing rotational movement to the screw for advancement through the septum wall. The method further includes positioning the screw at a target stimulation site in the left heart cavity and providing rotational movement to the screw to anchor the lead at the target site.

Abstract: An epicardial stimulation lead includes a lead body having a connector at a proximal end for coupling the lead to a generator of an active implantable medical device. The lead also includes a distributor housing at a distal end of the lead body and means for anchoring the distal end of the lead body to the epicardium. The lead also includes an active part having a plurality of microcable conductors, the proximal ends being coupled to the distributor housing, the distal ends being free. Each microcable has a diameter of at most equal to 2 French. Each microcable includes at least one denuded area in the insulating coating forming a stimulation electrode adapted to contact or penetrate an epicardium wall. Each microcable also includes a transverse elongated member extending at an angle relative to the main direction of the microcable for penetrating into the epicardial wall.

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. One method includes collecting, using an implantable device, reference episodes; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate a heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

Abstract: A lead for active implantable medical devices comprising a chip, notably for electrode multiplexing. The lead (10) includes an insulating supporting tube (20) interposed in a flexible elongated tube, with a central bore (22) coaxial with the lumen of the lead. The supporting tube comprises on its surface at least one crossing conductive strip (28) extending in the axial direction. A chip (18) on a flexible substrate is disposed with a bent or curved conformation in a receptacle of the supporting tube isolated from the conductive strip. An electrode, e.g., for cardiac sensing/pacing, (16) on the supporting tube (20) is electrically connected to an outer conductive pad (24) of the chip. The conductive strip is connected (i) at each end (28b), face to face to a conductive connection (12), housed in the sheath, and (ii) in a central region (28a), to an inner conductive pad (26) of the chip.

Abstract: Performing a capture test on a stimulated cardiac cycle based on the analysis of a cardiac vectogram using an active medical device including circuits and control logic for delivering electrical stimulation pulses to a heart chamber; collecting electrical activity of the heart chamber and producing two distinct temporal components (Vbip, Vuni) from two distinct intracardiac electrogram EGM signals from the heart chamber. The capture test detects an occurrence of a depolarization wave induced by the stimulation of the heart chamber, and determines a two-dimensional non-temporal characteristic (VGM) representative of the stimulated cardiac cycle, from the variation of one of the temporal components (Vuni) versus the other temporal component (Vbip). A bi-dimensional analysis delivers at least one descriptor parameter of the two-dimensional non-temporal characteristic, and determines a presence or loss of a capture based on the at least one descriptor parameter.

Abstract: A method for powering an autonomous intracorporeal leadless capsule includes the step of receiving a slow pressure variation at an external surface of a deformable member on the capsule. The deformable member is displacing in response to the slow pressure variation. The method further includes using a high pass mechanical filter to prevent the displacement from being transferred to an energy harvesting circuit within the capsule. The method further includes receiving a fast pressure variation at the external surface of the deformable member on the capsule, the deformable member displacing in response to the fast pressure variation. The method further includes via the high pass mechanical filter, passing the displacement to the energy harvesting circuit and creating energy using the displacement provided to the energy harvesting circuit.

Abstract: An active implantable medical device (e.g., implantable pacemaker or defibrillator), for detection of QRS complexes in noisy signals. Functional units (12-16) collect, amplify, prefilter and convert from analog-to-digital an endocardial signal, and digital functional units (18) provide signal processing and analysis of the digitized signal, for delivery of an indicator corresponding to a signal peak detection representative of the presence of a QRS complex in the endocardial signal. A double threshold comparator (30) is employed, receiving as input (28) the digitized signal and outputting (40) the indicator of peak detection when, cumulatively: the amplitude (A) of the input signal exceeds a peak amplitude threshold (SA), and the peak amplitude threshold is exceeded for a period (W) greater than a peak width threshold (SW). The peak amplitude threshold (SA) is a variable adaptive threshold, according to a noise level calculated from the energy (RMS) of the input signal.

Abstract: A heat dissipating housing to be positioned at a distal end of a stimulation/defibrillation lead, the housing including a housing body having a distal contact face at a distal end, an inner wall, and an outer wall. The housing further includes an anchoring screw, wherein at least a portion of the anchoring screw extends axially from the distal end of the housing body. The anchoring screw is configured to secure the distal contact face in contact with tissue of a patient to form a thermal bridge between the tissue and the housing body. The housing body is electrically insulated and thermally conductive to dissipate heat transferred through the thermal bridge to the outer wall of the housing body.

Abstract: A sensing/pacing lead including a microcable having a diameter of at most 2 French (0.66 mm). The microcable includes an electrically conductive core cable including a plurality of strands and a composite structure formed from at least a structuring material and a radiopaque material, the radiopaque material constituting at least about 0.008 mm2 of the core cable cross section. The plurality of strands of the core cable comprises a first set of individual strands formed from the structuring material and a second set of individual strands formed from the radiopaque material, or a plurality of strands each comprising a first and second layer, one of which is the structuring material and the other the radiopaque material. The microcable further includes a polymer insulation layer at least partially surrounding the core cable and at least one electrode.

Abstract: An active implantable medical device for vagal stimulation with optimization of ventricular filling is disclosed. The device delivers stimulation pulses to the vagal nerve of the patient with an adjustable energy level. The device includes a hemodynamic sensor for measuring hemodynamic parameters of the patient's cardiac cycles and delivering a timing parameter representative of the ventricular filling time. The energy level of the vagal stimulation pulses is adjusted dynamically and repeatedly over several cardiac cycles. The energy level is varied during successive cardiac correlative changes in the filling time (FT1, FT2) are assessed (46), and the energy level is set to a level that maximizes the ventricular filling time.

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.