Abstract: This device includes a sensor of endocardiac acceleration EA and one or more circuits configured for: extracting from the EA signal a predetermined EA parameter, determining a period of sleep, evaluating the clinical condition of the patient based on the EA parameter variations on this sleep period, and issuing an alert of worsening of the patient's condition. The device further determines a variability index of the EA parameter on the sleep period, and then calculates a ratio between this calculated variability index and a reference value, and delivers this ratio as a clinical status index. The alert signal is generated by the crossing by this ratio of a predetermined alert threshold.

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: A multizone epicardial pacing lead (10) having a lead body (12) with a proximal connector (14) for coupling to a generator of an active implantable medical device and, distally, an anchor to an epicardium wall and an active part comprising a plurality of stimulation electrodes, coming into contact with, or penetrating, the epicardium wall. This active part comprises a distributor housing (16) and a network of flexible microcables (18) radiating from the housing. Each microcable is formed of an electrically insulated conductor comprising at least one denuded area (20), each of these areas forming a stimulation electrode.

Abstract: Methods, devices, and processor-readable storage media are provided for the diagnosis of heart failure. A method in this context includes collecting, using an implantable device, reference episodes, the reference episodes comprising, at least one of: electrical activity signals of a myocardium; myocardium hemodynamic activity signals, or indicators reflecting variation of physical parameters, variation of activity, and variation of hemodynamic phases between phases of effort and phases of recovery; generating an in-suspicion model-cycle and an off-suspicion model-cycle based on the reference episodes; and determining whether to generate an early heart failure alert, based on a difference between the in-suspicion model-cycle and the off-suspicion model-cycle.

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: Systems, methods, and devices for activating an implantable medical device from a low-power sleep state are provided. One method includes receiving a wake-up signal at a receiver device from a transmitter device. The wake-up signal includes a series of pulses having a pulse pattern encoding a predetermined wake-up code. The wake-up signal is transmitted via intracorporeal communication of electrical pulses conducted by interstitial tissues of a patient's body. The method further includes extracting the wake-up code from the wake-up signal and determining whether the wake-up code corresponds to a stored wake-up value. The method further includes, in response to determining that the predetermined wake-up code corresponds to the stored wake-up value, switching at least one active circuit element of the receiver device from a lower-power sleep state into a higher-power operational state.

Abstract: A lead for an implantable cardiac prosthesis, with protection against the thermal effects of MRI fields by terminating the lead head (10) with an electrically insulating tubular outer housing (28) and an anchoring mechanism. The tubular housing (28) carries an electrically isolated thermally conductive solid part in the outer region of its distal end forming a heat sink. The heat sink thermally conductive material is for example titanium, associated with an electrically insulating coating such as a diamond deposition. The anchor may be a projecting helical anchoring screw (20), axially extending the tubular housing, which is an electrically conductive active screw on at least one end portion.

Abstract: Apparatus and methods for communicating between an apparatus, such as a medical device, and a remote device are provided. One method includes determining a first indicator representative of a long-term availability for each of a plurality of channels for communication between a medical device and a remote device. The method further includes receiving a communication request from the remote device and, in response to the communication request, determining a second indicator representative of a short-term availability for each of the plurality of channels. The method further includes selecting a communication channel from the plurality of channels based on the first and second indicators.

Abstract: A plug includes a pin having an axial contact at its opposite end with a mounting rod connected to a center conductor. At the interface between the pin and the inner wall of the plug body, a support sleeve mounted on the shaft and bearing axially against a collar formed on said rod is provided. Axially, a locking ring is secured to the shaft so that the support sleeve is clamped between the collar of the rod and the locking ring, if necessary, leaving a degree of freedom of rotation between the sleeve and the pin. Radially, the outer surface of the sleeve comes into direct contact with the inner wall of the bore of the plug body, to which it is directly secured. The direct attachment of the sleeve to the plug body may be obtained by a snap-in connection with notches cooperating with a counterpart groove.

Abstract: A kit for penetrating the cardiac septum and for implanting a transeptal lead, including a lead for the detection/stimulation of a left heart cavity. This kit includes a screw lead (16) and a radio-frequency puncture generator (32). The lead includes: a lead body with a deformable sheath (18); a proximal end having an electrical connector (20) for coupling to an implanted medical device housing; a distal end having a lead head (22) with an electrode including a projecting conductive helical screw (24) for penetrating into the septum (10) due to a screw movement applied from the proximal end of the lead, and a conductor (26) connecting the electrode to the electrical connector, the electrode including the screw.

Abstract: A system and method for implantation of an autonomous intracardiac capsule. The autonomous capsule includes a cylindrical body with an anchoring screw for penetrating a tissue wall, and at least one coupling finger radially projecting outwards. An implantation accessory includes a lead body and a helical guide, for guiding and driving by rotation the capsule. This helical guide is integral with the lead body, and its inner diameter is sufficient to contain that cylindrical body of the capsule therein. The helix direction of the helical guide is opposite to that of the anchoring screw such that continued rotational motion imparted on the lead body drives the anchoring screw into the target tissue and then emerges the capsule from the helical guide. The helical guide is resiliently compressible in axial direction, and its helix pitch is increased in the free distal end portion.

Abstract: An active implantable medical device, notably a device for pacing, resynchronization defibrillation and/or cardioversion, and/or a device for diagnosing patient conditions, having a predictive diagnosis of the patient's status. The device measures a physiologic parameter, notably the minute ventilation (MV); measures a physical parameter, notably the acceleration (G); discriminates between phases of activity and rest of the patient; and includes a memory containing a plurality of fields selectively updated by statistical processing. These fields are comprising one first set (22) containing data related to the patient's activity phases, and one second set (24) containing data related to the patient's rest phases.

Abstract: An implantable cardiac prosthesis device conducting an analysis of a patient tolerance to a pacing mode favoring the spontaneous atrioventricular conduction is disclosed. The device operates in a dual chamber (DDD or biventricular) mode and in a pacing mode favoring the spontaneous atrioventricular conduction such as an AAI mode (10) with a ventricular sensing or a mode with hysteresis of the atrioventricular delay. The device controls (10-18) the conditional switching from one mode to the other. The device comprises a hemodynamic sensor, including an endocardial acceleration sensor, derives a hemodynamic index representative of the hemodynamic tolerance of the patient to the spontaneous atrioventricular conduction. The device controls inhibiting or (20) forcing the conditional switching of the device to the DDD (or biventricular) mode according to the evolution of the hemodynamic index.

Abstract: A connector for a multipolar lead has a cavity that contains a stack of alternating annular electrical contact elements and annular isolation elements. The isolation elements comprise an annular rigid sleeve and an annular flexible seal disposed against an annular face in an interior region of the rigid sleeve. The flexible seal extends axially from one lateral side of the rigid sleeve to the other in the interior region of the rigid sleeve. The sleeve and the seal include are immobilized relatively to each other in the axial direction by use of mating surface profiles respectively defined on an inner annular side of the sleeve and on an outer annular side of the flexible seal.

Abstract: A closed loop Deep Brain Stimulation (DBS) system constituted of: a physiological sensor; a multi-electrode DBS lead; an adaptive control system in communication with the physiological sensor; and an implantable pulse generator (IPG) responsive to the adaptive control system, the adaptive control system comprising a learning module operable to learn to find the optimal stimulation parameters, classify and associate patient conditions responsive to the physiological sensor with optimal stimulation parameters in a plurality of patient conditions. The adaptive DBS device control system learns to deliver the optimal stimulation parameters based on Watkins and Dayan Q learning recursive formula, the closed loop adaptive DBS control system thus finds the optimal stimulation parameters online.

Abstract: Device for adaptive processing of an endocardial acceleration signal. The device 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 patients 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 pre-processing parameters for calculating the EA signal average.

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 an electrical conductor of connection extending in an internal lumen of the sheath core. In one embodiment of the invention, 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 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: Methods, devices, and processor-readable storage media are provided for detecting spontaneous ventricular events in a heart using implantable medical devices. A method in this context includes applying a sensitivity function to collected data to detect occurrence of ventricular events. The sensitivity function is based on an adjustable detection threshold. The method further includes determining whether noise is suspected to be present in the data and, if so, increasing the threshold. The method further includes providing a stimulation pulse to the heart when a ventricular event has not occurred after a predetermined escape interval and, following the stimulation pulse, applying a capture test to detect whether an induced depolarization has occurred. If induced polarization is not detected, the threshold is reduced, while the threshold is maintained if induced polarization is detected.

Abstract: A left atrial appendage (LAA) occlusion system and a method for occluding the LAA are disclosed. The LAA occlusion plug includes at least two expandable materials having shrunken and swollen states, two plates and a delivery tool configured to deliver the occlusion plug to the LAA. The LAA occlusion plug is configured to permanently occlude the LAA opening, such that blood clots cannot flow out of the LAA when the at least two hydrogels are in the swollen state. The LAA occlusion plug plates are configured to force the expandable materials to swell inwards in the axial direction and outwards in the radial direction such that the LAA occlusion plug is clipped to the LAA opening tissue.

Abstract: An intracorporeal capsule for placement in a heart and for energy harvesting using blood pressure variations is shown and described. The capsule includes a capsule body and a piezoelectric strip coupled to a rigid surface for receiving blood pressure force. The piezoelectric strip is normally perpendicular to the direction of the force on the rigid surface. The piezoelectric strip is disconnected from the capsule body along at least two edges of the piezoelectric strip such that the blood pressure force can move the rigid surface, and thereby deform the piezoelectric strip for energy harvesting.