Abstract: An implantable biocompatible component (10) integrating an active element of the type of a sensor for the measurement of a physiologic parameter, a micro-electromechanical system and an integrated electronic circuit. This component (10) has a substrate (12) and a lid (22) in silicon or quartz. The substrate (12) integrates the active element (14) and biocompatible metallic pads (16), electrically connected to the active element. The lid (22) encompasses and peripherally closes the substrate in a hermetic manner, level with the face integrating the active element. This component is void of metallic case for insulation between the active element and outside environment, and of insulative feedthrough for electrical connection to the active element. The substrate and lid can be directly welded to each other through their faces in vis-à-vis, or by interpositioning a sealing ring made of a biocompatible material.

Abstract: A circuit for controlled commutation of multiplexed electrodes, for an active implantable medical device. This circuit is located in a lead equipped with multiplexed sensing/pacing electrodes. This circuit decodes a signal generated by a generator, commanding a series of switches, which ensures selective coupling of the various electrodes to the proximal and distal terminals of the generator. This signal is a modulated signal comprising a coded series of logic pulses defining a particular configuration for coupling the lead electrodes to the proximal or distal terminal of the generator. The signal comprises a micropulse, that precedes the coded series of logic pulses and has an amplitude and duration lower than the amplitude and duration of each of the logic pulses. The detection of this micropulse activates, in response, all the circuit switches to an open position over a duration (PHASE 1) at least equal to the duration of reception of the coded series of logic pulses.

Abstract: A remote support system for programming active implantable medical devices such as cardiac pacemakers, defibrillators, cardioverters or multisite devices. A station is equipped with a programmer that is able to read, by telemetry, information stored in an implantable device, and transmit over a telephone line the information thus read, namely patient data and/or internal parameters for operating the programmer or programming parameters of the implant. A remote analysis station is configured to receive the information sent on the telephone line and display and/or analyze the transmitted information. The programmer includes an input to collect a voice signal and a multiplexor so that the data and/or parameters and the voice signal collected, are simultaneously delivered at the multiplexor output in real-time as a multiplexed signal that, in turn, is applied to a tele-transmission circuit (e.g., a modem).

Abstract: An active implantable medical device including a generator connected to a right ventricular electrode and a left ventricular electrode. The generator includes two output terminals connected to the ventricular electrodes, to deliver joint stimulation impulses with an adjustable inter-ventricular delay. The generator is a generator of the double chamber pacemaker type including an atrial terminal, a ventricular terminal, and circuits for jointly delivering at the atrial and ventricular terminals stimulation impulses with an adjustable atrio-ventricular delay. One of the outputs is the atrial terminal and the other is the ventricular terminal, the atrio-ventricular delay being adjusted with the value of the inter-ventricular delay.

Abstract: A circuit for controlled commutation of multiplexed electrodes, for an active implantable medical device. This circuit is located in a lead equipped with multiplexed sensing/pacing electrodes. This circuit decodes a signal generated by a generator, commanding a series of switches, which ensures selective coupling of the various electrodes to the proximal and distal terminals of the generator. This signal is a modulated signal comprising a coded series of logic pulses defining a particular configuration for coupling the lead electrodes to the proximal or distal terminal of the generator. The signal comprises a micropulse, that precedes the coded series of logic pulses and has an amplitude and duration lower than the amplitude and duration of each of the logic pulses. The detection of this micropulse activates, in response, all the circuit switches to an open position over a duration (PHASE 1) at least equal to the duration of reception of the coded series of logic pulses.

Abstract: An implantable biocompatible component (10) integrating an active element of the type of a sensor for the measurement of a physiologic parameter, a micro-electromechanical system and an integrated electronic circuit. This component (10) has a substrate (12) and a lid (22) in silicon or quartz. The substrate (12) integrates the active element (14) and biocompatible metallic pads (16), electrically connected to the active element. The lid (22) encompasses and peripherally closes the substrate in a hermetic manner, level with the face integrating the active element. This component is void of metallic case for insulation between the active element and outside environment, and of insulative feedthrough for electrical connection to the active element. The substrate and lid can be directly welded to each other through their faces in vis-à-vis, or by interpositioning a sealing ring made of a biocompatible material.

Abstract: An active implantable medical device including a generator connected to a right ventricular electrode and a left ventricular electrode. The generator includes two output terminals connected to the ventricular electrodes, to deliver joint stimulation impulses with an adjustable inter-ventricular delay. The generator is a generator of the double chamber pacemaker type including an atrial terminal, a ventricular terminal, and circuits for jointly delivering at the atrial and ventricular terminals stimulation impulses with an adjustable atrio-ventricular delay. One of the outputs is the atrial terminal and the other is the ventricular terminal, the atrio-ventricular delay being adjusted with the value of the inter-ventricular delay.

Abstract: A remote support system for programming active implantable medical devices such as cardiac pacemakers, defibrillators, cardioverters or multisite devices. A station is equipped with a programmer that is able to read by telemetry information stored in an implantable device and transmit over a telephone line, the information thus read, namely patient data and/or internal parameters for operating the programmer or programming parameters of the implant. A remote analysis station is configured to receive the information sent on the telephone line and display and/or analyze the transmitted information. The programmer includes an input to collect a voice signal and a multiplexor so that the data and/or parameters and the voice signal collected, are delivered at the multiplexor output as a multiplexed signal that, in turn, is applied to a tele-transmission circuit, e.g., a modem.

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: 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: 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: 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: An active implantable medical device, in particular a pacemaker, defibrillator and/or cardiovertor, including a circuit for recording cardiac events. This device records cardiac events or parameters representative of cardiac events, such that the recording of the current cardiac events replaces that of the oldest events previously recorded. The device inhibits the recording operation so as to stop the recording of the cardiac events and/or event markers in response to it being established that the patient has died. The inhibition can be obtained by detecting spontaneous or stimulated cardiac activity, advantageously combined with the detection of a parameter indicative of the patient's metabolic demand, such as the activity or effort of the patient, so that the inhibition occurs only in the event of the detection of an absence of cardiac activity confirmed by an absence of activity and/or effort of the patient.

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 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 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: An active implantable medical device, especially a cardiac pacemaker, defibrillator and/or cardiovertor, of the configurable multisite type. In this multisite device, electrodes are placed in at least three distinct myocardial sites for stimulation (12, 14, 20, 22), of which at least one is a site for ventricular stimulation/detection (14, 22), these electrodes being connected to independent outputs (DA, DV, Da1, Dv2) of the multisite device in a manner as to allow the application of stimulation pulses produced by a plurality of distinct stimulation stages (24, 26, 28, 30). The number of stimulation output stages is at most equal to the number of stimulation sites. The device also includes switches (SA, SV, S1, S2) to connect selectively and according to one of various possible stimulation configurations, the stimulation stages, or selected ones of the stimulation stages, to the various sites of stimulation, or to selected ones of the stimulation sites.

Abstract: An active implantable medical device of the defibrillator/cardioverter type for the defibrillation or cardioversion of the atrium. The device is able to detect ventricular activity and to deliver conventional low energy ventricular stimulation pulses to the ventricle. It also delivers shock energy pulses having an energy level sufficient to achieve defibrillation and/or cardioversion. The atrial activity is detected to determine the moment at which the shock energy pulse can be delivered to the atrium. The device also recognizes when a ventricular depolarization occurs, and uses this event to control in a conditional manner the delivery of shock energy pulses. More particularly, shock energy pulses are delivered only when the detected ventricular activity indicates the occurrence of a ventricular depolarization following delivery of a ventricular stimulation pulse.

Abstract: An active implanted medical device of the implantable defibrillatory cardioverter type. This device comprises an atrial electrode (40), a ventricular electrode (50), at least one electrode external to the heart (70, 80) and a pulse generator (60). The pulse generator comprises a means for delivering a shock energy pulse for defibrillation or cardioversion, and means for switching the electrode configuration, that determines between which electrodes the defibrillation or cardioversion shock energy pulse is to be applied. The switching means operates in response to the determined delivery of a cardioversion shock pulse energy, by disconnecting the atrial electrode from the means for delivering the shock energy pulse for defibrillation or cardioversion, and, if the configuration of electrodes determined by the switching means foresees the commutation of the atrial electrodes a return electrode, then to substitute for the atrial electrode at least one of electrodes external to the heart.