Abstract: An apparatus for non-invasive diagnosis of states of vasovagal syncope in a patient placed on a tilt table and subjected to a tilt-test, the apparatus comprising: circuits for sensing the patient's endocardiac acceleration; circuits for sensing the patient's heart rate; and analyzer circuits receiving as inputs said endocardiac acceleration and said heart rate, and outputting information about the sympthetico-vagal activity of the patient. The circuits for sensing endocardiac acceleration comprise an external accelerator sensor suitable for being held in contact with the patient's rib cage. The analyzer circuits comprise classifier circuits suitable, in the event of a syncope occurring, for determining one type of syncope amongst a plurality of syncope types as a function of the endocardiac acceleration and heart rate values sensed during a plurality of heart cycles preceding the occurrence of the syncope.

Abstract: Improved management of respiratory pauses (apnea) or hypopnea in an active implantable medical device of the cardiac pacemaker, cardiovertor and defibrillator types including multisite devices. This device operates to analyze the patient's respiratory activity, detect the occurrence of respiratory pauses (apnea) or diminutions (hypopnea), analyze the contractility of the myocardium, for example, by measurement of the intracardiac impedance or the endocardial acceleration, and detect the occurrence of a variation of the hemodynamic state. In the event of a significant variation of the hemodynamic state (i.e., contractility) detected in relation to the detection of an apnea or of an hypopnea, the device modifies conditionally and temporarily an operating parameter of the device, for example, the frequency of stimulation, the atrio-ventricular delay or to trigger a multistate stimulation to compensate.

Abstract: An active implantable medical device having a function for monitoring the sympathico-vagal activity by an analysis of endocardiac acceleration. The device collects at least one physiological parameter of the patient, analyzes that collected parameter and delivers at an output data representative of the sympathico-vagal activity of the patient. The physiological parameter is an endocardiac acceleration (EA), and the representative data include at least one value function of the endocardiac acceleration, in particular a function of a first peak (PEA I) at the time of the phase of isovolumic ventricular contraction and/or of a second peak (PEA II) at the time of the phase of isovolumic ventricular relieving.

Abstract: A system of connection of a probe terminal to a connection head of an implantable medical device. A connection terminal is assembled at the proximal end of a probe to be inserted in a cavity of a connector head of the housing of an implantable medical device. The connection terminal is covered on its external surface by a layer of anti-adhesion material, in particular a carbon film laid down by cathodic sputtering with a thickness less than 1 ?m. In the alternative, the layer can be applied on the interior wall of the cavity of the connector head.

Abstract: An apparatus for non-invasive diagnosis of states of vasovagal syncope in a patient placed on a tilt table and subjected to a tilt-test, the apparatus comprising: circuits for sensing the patient's endocardiac acceleration; circuits for sensing the patient's heart rate; and analyzer circuits receiving as inputs said endocardiac acceleration and said heart rate, and outputting information about the sympthetico-vagal activity of the patient. The circuits for sensing endocardiac acceleration comprise an external accelerator sensor suitable for being held in contact with the patient's rib cage. The analyzer circuits comprise classifier circuits suitable, in the event of a syncope occurring, for determining one type of syncope amongst a plurality of syncope types as a function of the endocardiac acceleration and heart rate values sensed during a plurality of heart cycles preceding the occurrence of the syncope.

Abstract: A system of connection of a probe terminal to a connection head of an implantable medical device. A connection terminal is assembled at the proximal end of a probe to be inserted in a cavity of a connector head of the housing of an implantable medical device. The connection terminal is covered on its external surface by a layer of anti-adhesion material, in particular a carbon film laid down by cathodic sputtering with a thickness less than 1 ?m. In the alternative, the layer can be applied on the interior wall of the cavity of the connector head.

Abstract: An active implantable medical device having a function for monitoring the sympathico-vagal activity by an analysis of endocardiac acceleration. The device collects at least one physiological parameter of the patient, analyzes that collected parameter and delivers at an output data representative of the sympathico-vagal activity of the patient. The physiological parameter is an endocardiac acceleration (EA), and the representative data include at least one value function of the endocardiac acceleration, in particular a function of a first peak (PEA I) at the time of the phase of isovolumic ventricular contraction and/or of a second peak (PEA II) at the time of the phase of isovolumic ventricular relieving.

Abstract: Improved management of respiratory pauses (apnea) or hypopnea in an active implantable medical device of the cardiac pacemaker, cardiovertor and defibrillator types including multisite devices. This device operates to analyze the patient's respiratory activity, detect the occurrence of respiratory pauses (apnea) or diminutions (hypopnea), analyze the contractility of the myocardium, for example, by measurement of the intracardiac impedance or the endocardial acceleration, and detect the occurrence of a variation of the hemodynamic state. In the event of a significant variation of the hemodynamic state (i.e., contractility) detected in relation to the detection of an apnea or of an hypopnea, the device modifies conditionally and temporarily an operating parameter of the device, for example, the frequency of stimulation, the atrio-ventricular delay or to trigger a multistate stimulation to compensate.

Abstract: Electrodes can generate electrical stimulation pulses at least one first intensity level and at least one second intensity level. The first and second intensity levels are above and below a given stimulation threshold, respectively. The synchronous or asynchronous delivery of second-level pulses enables the conduction of the atrioventricular node to be modulated by electrotonic effect, for example, to reduce ventricular frequency in the event of atrial fibrillation.

Abstract: An implantable dual-chamber pacemaker system has a means for automatic beat-to-beat adjustment of the maximum allowable variation (MAV) of the sensed atrial rate (AR) as a function of the sympatho-vagal balance, switching from an atrial tracking mode of operation (e.g., DDD or DDD(R)) to a non atrial tracking mode (e.g., VDI or VDI(R)) when either an arrhythmic tachycardic rate, exceeding the MAV, or a sinus tachycardic rate, exceeding the maximum tracking atrial rate (MTAR), is detected. The pacemaker provides logic means for continuously determining the atrial rate variation (&Dgr;AR) and the MAV. The MAV defines the upper limit for the &Dgr;AR above which tracking is not allowed, discriminating between physiological rate variations and arrhythmic variations. The pacemaker system can return to an atrial tracking mode of operation if the AR remains under a defined rate for a defined number of cycles.

Abstract: An implantable dual-chamber pacemaker system has a means for automatic beat-to-beat adjustment of the maximum allowable variation (MAV) of the sensed atrial rate (AR) as a function of the sympatho-vagal balance, switching from an atrial tracking mode of operation (e.g., DDD or DDD(R)) to a non atrial tracking mode (e.g., VDI or VDI(R)) when either an arrhythmic tachycardic rate, exceeding the MAV, or a sinus tachycardic rate, exceeding the maximum tracking atrial rate (MTAR), is detected. The pacemaker provides logic means for continuously determining the atrial rate variation (&Dgr;AR) and the MAV. The MAV defines the upper limit for the &Dgr;AR above which tracking is not allowed, discriminating between physiological rate variations and arrhythmic variations. The pacemaker system can return to an atrial tracking mode of operation if the AR remains under a defined rate for a defined number of cycles.

Abstract: An implantable defibrillator apparatus having a plurality of defibrillation electrodes which can be applied to the heart muscle in order to apply electric defibrillation shocks thereto, and a defibrillation-controller for selectively applying respective electric defibrillation shocks to the electrodes preferably sequentially in time and in synchronism with the QRS.

Abstract: An implantable heart-stimulation apparatus having a plurality of stimulation electrodes which can be applied to the heart muscle in one or more chambers of the heart in order to apply electrical stimulation signals thereto, and stimulation-control means for applying stimulation signals to the electrodes in accordance with a time plan determined individually and separately for each of the plurality of electrodes.

Abstract: A device for locating an electrode used in endocardial treatment comprises further electrode means to be positioned inside the heart together with the electrode, the further electrode means being able to adopt a geometrical arrangement defining a system of spatial coordinates. Polarization means are provided for applying respective electrical signals to at least one of the electrode and the further electrode means, as well as detector means connected to the electrode and to the further electrode means for detecting the potential established between the electrode and the further electrode means as a result of the application of the electrical signals. Measuring means sensitive to the potential are capable of determining, on the basis of the potential, the position of the electrode relative to the system of spatial coordinates defined by the further electrode means.

Abstract: Electrodes can generate electrical stimulation pulses at least one first intensity level and at least one second intensity level. The first and second intensity levels are above and below a given stimulation threshold, respectively. The synchronous or asynchronous delivery of second-level pulses enables the conduction of the atrioventricular node to be modulated by electrotonic effect, for example, to reduce ventricular frequency in the event of atrial fibrillation.

Abstract: An implantable defibrillator apparatus having a plurality of defibrillation electrodes which can be applied to the heart muscle in order to apply electric defibrillation shocks thereto, and defibrillation-control means for selectively applying respective electric defibrillation shocks to the electrodes preferably sequentially in time and in synchronism with the QRS.

Abstract: Electrodes can generate electrical stimulation pulses at least one first intensity level and at least one second intensity level. The first and second intensity levels are above and below a given stimulation threshold, respectively. The synchronous or asynchronous delivery of second-level pulses enables the conduction of the atrioventricular node to be modulated by electrotonic effect, for example, to reduce ventricular frequency in the event of atrial fibrillation.

Abstract: An implantable defibrillator apparatus having a plurality of defibrillation electrodes which can be applied to the heart muscle in order to apply electric defibrillation shocks thereto, and defibrillation-control means for selectively applying respective electric defibrillation shocks to the electrodes preferably sequentially in time and in synchronism with the QRS.

Abstract: In one embodiment, the structure comprises, in addition to a body which is usually cylindrical or tubular, a plurality of tines which extend radially from the body. The tines, which are usually flat in shape and tapered, are positioned, relative to the body, with a keying angle other than zero and hence in a generally helical arrangement. The principal axes of the tines in question are preferably also inclined to the longitudinal axis of the body, giving rise to a generally anchor-like shape.