Abstract: A device includes a processor configured to detect a respiratory disorder episode and generate kinesthetic stimulation control signals in response to the detection of a respiratory disorder episode. The device further includes at least one kinesthetic effector adapted to be applied to a patient's outer skin site and includes a vibrating electromechanical transducer capable of receiving stimulation control signals and outputting a kinesthetic stimulation energy determined by the stimulation control signals. The processor is further configured to determine the effectiveness of stimulation by detecting a cessation of the respiratory disorder episode. The processor is further configured to determine a stimulation energy by selecting an initial energy value and varying the energy value as a function of the effectiveness of previous stimulation.

Abstract: An active implantable medical device for neurostimulation therapy is disclosed. The device produces stimulation pulse sequences generated continuously in succession during activity periods separated by intermediate inactivity periods during which no stimulation is issued. An input signal, provided by a physiological sensor, representative of cardiac activity and/or of the patient's hemodynamic status is received by circuitry. The circuitry further provides for dynamic control of the neurostimulation therapy, wherein the length of activity periods is modulated based on the current value level of the control parameter compared to a threshold. The duration of the next period of inactivity is calculated by the circuitry at the end of each activity period to maintain a constant duty cycle ratio between periods of activity and periods of inactivity.

Abstract: A microlead has a distal active portion formed by a microcable including an electrically conductive core coated with an insulation layer, with a plurality of exposed areas forming the stimulation electrodes. The microcable has a three-dimensional preshape inscribed in a cylindrical envelope volume so as to match the target vessel wall. The microcable includes a plurality of exposed areas regularly distributed over the circumference of the cylindrical envelope volume considered in axial projection, the exposed zones extending only over an angular sector of the microcable considered in cross section, said angular sector facing the outside of the envelope volume of the preshape.

Abstract: A device for treating sleep apnea in a patient through stimulation. The device includes a generator configured to produce stimulation pulses, a stimulator that receives the stimulation pulses produced by the generator and delivers stimulation to the patient, and a controller. The controller is configured to determine a sleep state of the patient, adaptively control the generator based on the sleep state where the sleep state includes a plurality of sleep stages, and modulate a stimulation energy of the stimulation pulses produced by the generator based on the sleep stage of the patient.

Abstract: An implantable cardiac device that detects and protects against strong magnetic fields produced by MRI equipment is disclosed. The device has a magnetic field sensor for detecting the presence of a relatively weak static magnetic field (102, 110, 118, 122) of a level equivalent to that of a permanent magnet in the vicinity of the device. The device is switched from a standard operating mode (100) where the nominal functions of the device are active, to a specific protected MRI mode (114, 116) in the presence of a magnetic static field of a level corresponding to that emitted by MRI equipment. The device further temporarily switches the device from the standard operating mode (100) to an MRI stand-by state (108) when a magnetic field is detected by the magnetic field sensor such that a subsequent detection of a magnetic field switches the device from an MRI stand-by state to the specific protected MRI mode.

Abstract: This accessory comprises a remotely steerable catheter (40) extended by a tip (50) comprising a base (52) to which the catheter (40) connects to and a cylindrical portion (54) defining a volume (56) suitable for housing the capsule (10). A sub-catheter (30) and the capsule are telescopically extendable with respect to the catheter between i) a retracted position and a deployed position wherein the capsule is removed from the connector and is carried by the distal end of the sub-catheter, and the distal end of sub-catheter and the proximal region (18) of the capsule being provided with disconnectable means of attachment (20, 36). The tip presents, between its base (52) and its cylindrical portion (54), a flexible portion (58) providing, between the base and the cylindrical portion, an elastic deformability in bending and compression.

Abstract: An autonomous capsule includes a tubular body provided at its distal end with an anchoring screw, and in its proximal region of a capture groove. An explantation accessory includes a reinforced catheter combined with a flexible wire which can slide in the catheter and has a deformable loop which can be clamped by gradual introduction of its ends in the catheter under the effect of a traction exerted on the wire. During tightening, the capture groove receives the wire loop, allowing, after complete tightening, to secure in tension and rotation an assembly formed by the catheter, the capsule, and the wire. The reinforced catheter is then used to transmit a tensile force and an axial torque from its proximal end to its distal end, allowing safe unscrewing of the capsule and its extraction through the patient venous network.

Abstract: A hybrid system forming an active implantable medical device includes a subcutaneous autonomous capsule and at least one intracorporeal autonomous leadless capsule. The subcutaneous capsule is a hybrid capsule having a seal body of dimensions comparable to those of a leadless capsule, but extended by a detection/stimulation microlead, without any intermediate connector. The leadless capsule includes a seal body, anchoring means in a wall of an organ and a detection/stimulation electrode. The hybrid capsule and the leadless capsules each include transmitter/receiver means for intracorporeal mutual wireless communication so as to constitute a network wherein the hybrid capsule is the master and leadless capsules are the slaves. The hybrid capsule further includes means for centralizing data transmitted by the leadless capsules and for exchanging data with remote external equipment.

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: A microlead, of an overall diameter less than 0.5 mm, includes a plurality of at least eight conductor wires individually insulated and twisted together. Each conductor wire includes an electrically conductive core microcable and an insulation layer surrounding the core microcable and having at least one exposed area to form a detection/stimulation electrode of the microlead. The microlead further includes a central support structure shaped as a surface of revolution, which may be free of conductor wires and of central lumen. The conductor wires are configured in one or more layers of twisted peripheral conductor wires carried by the central support structure and circumferentially distributed thereon.

Abstract: A method of manufacturing a detection/stimulation lead for implantation into a venous, arterial, or lymphatic network is shown and described. The method includes providing a microcable comprising a sheath of insulating material covering an electrically conductive core. The method further includes surrounding a portion of the microcable with an electrically conductive metal ring. The method also includes crimping the ring such that the thickness of the sheath is penetrated by a portion of the metal ring and such that an electrical connection is formed between the metal ring and the electrically conductive core.

Abstract: The invention relates to an active implantable medical device. The device includes a VNS pulse generator, an activity sensor for detecting a patient's current activity level, and a processor. The processor is configured to collect the electrical activity of the heart, such as a current intrinsic heart rate of the patient. The processor further calculates values of a reference heart rate based on the patient's current activity level. A first histogram is constructed from the reference heart rate values, and a second histogram is constructed from the intrinsic heart rate values. An index representative of the patient's condition is derived by comparing the first and second histograms.

Abstract: This disclosure relates to an implantable probe for electrical stimulation of an organ and/or for detection of electrical potentials on this organ. The probe comprises a distal end able to come into contact with the tissues of the organ, this end comprising an insulating substrate, and at least one conductive interface carried by the substrate. The probe further comprises a probe body having at least one bonding conductor connected to a respective conductive interface. The conductive interface comprises at least one deformable conductive wire, at least partially exposed, with a woven, embroidered, braided or knitted configuration for anchoring the deformable wire to the substrate.

Abstract: An active implantable medical device for neurostimulation therapy is disclosed. The device produces stimulation pulse sequences generated continuously in succession during activity periods separated by intermediate inactivity periods during which no stimulation is issued. An input signal, provided by a physiological sensor, representative of cardiac activity and/or of the patient's hemodynamic status is received by circuitry. The circuitry further provides for dynamic control of the neurostimulation therapy, wherein the length of activity periods is modulated based on the current value level of the control parameter compared to a threshold. The duration of the next period of inactivity is calculated by the circuitry at the end of each activity period to maintain a constant duty cycle ratio between periods of activity and periods of inactivity.

Abstract: The disclosure relates to a device including a plurality of electrodes for stimulation of both ventricles with application of an atrioventricular delay and of an interventricular delay, a processor configured to multidimensionally measure an interventricular conduction delay, and monitor the evolution of a patient's condition. For the multidimensional measurement of the interventricular conduction delay, the device produces stimulation of one of the ventricles and collects, in the other ventricle, two endocardial electrogram signals on separate respective channels, giving two respective temporal components. Both temporal components are combined in one single parametric 2D characteristic representative of the cardiac cycle, and a comparison is made with reference descriptors for deriving an index representative of the evolution of the patient's condition.

Abstract: An autonomous capsule includes a tubular body provided at its distal end with an anchoring screw, and in its proximal region of a capture groove. An explantation accessory includes a reinforced catheter combined with a flexible wire which can slide in the catheter and has a deformable loop which can be clamped by gradual introduction of its ends in the catheter under the effect of a traction exerted on the wire. During tightening, the capture groove receives the wire loop, allowing, after complete tightening, to secure in tension and rotation an assembly formed by the catheter, the capsule, and the wire. The reinforced catheter is then used to transmit a tensile force and an axial torque from its proximal end to its distal end, allowing safe unscrewing of the capsule and its extraction through the patient venous network.

Abstract: One system includes a stimulation device such as a vagus nerve stimulation lead, and a controller for controlling the stimulation device according to a set of stimulation parameters. A memory of the stimulation device contains a state transition model, and for each state defines a set of stimulation parameters and at least one expected response during the application of stimulation with the parameters. A matrix determines the transition rules between states based on physiological levels measured versus target levels. A state transition control unit determines, in an organized timely method, possible transitions between states according to the rules on physiological levels obtained in response to the implementation of the stimulation parameters of the current state, and a transition from a current state to a new state causes a corresponding change in the parameter set used for stimulation.

Abstract: The present disclosure relates to implantable capsules for stimulation. One implantable capsule includes a tubular body and a distal member provided at its distal end with an anchoring device adapted to penetrate into a tissue of a wall of an organ of a patient and a distal electrode, the body accommodating a set of functional elements of the capsule and including a proximal electrode. The capsule includes an electrically insulating member between the body and the distal member to isolate the distal member of said body.

Abstract: A medical device for stimulating the heart using biventricular stimulation. The device includes a sensor for detecting an endocardial acceleration parameter and a processing circuit configured to receive the endocardial acceleration parameter. The device further includes stimulation electronics coupled to the processing circuit. The processing circuit is configured to use the EA parameter to evaluate the biventricular stimulation. The evaluation includes comparing the value of the EA parameter in biventricular mode to the value of the EA parameter in left only mode or right only mode, and using the comparison and an assessment of the variability of the EA parameter as a function of the AVD in the left or right mode to distinguish between cases comprising: (a) normal operation, (b) a loss of RV or LV capture, (c) possible anodal stimulation. The processing circuit is further configured to conduct at least one update to operational parameters of the device based on the determined case.

Abstract: One system includes a stimulation device such as a vagus nerve stimulation lead, and a controller for controlling the stimulation device according to a set of stimulation parameters. A memory of the stimulation device contains a state transition model, and for each state defines a set of stimulation parameters and at least one expected response during the application of stimulation with the parameters. A matrix determines the transition rules between states based on physiological levels measured versus target levels. A state transition control unit determines, in an organized timely method, possible transitions between states according to the rules on physiological levels obtained in response to the implementation of the stimulation parameters of the current state, and a transition from a current state to a new state causes a corresponding change in the parameter set used for stimulation.