Abstract: A device for treating sleep apnea by discriminating between successive sleep stages of a patient 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, a sensor configured to measure a biological parameter of the patient, and a controller. The controller is configured to determine a state of the patient based on the biological parameter, perform a sleep analysis based on the state of the patient, activate the generator to trigger production of the stimulation pulses, determine a variation of the biological parameter subsequent to the production of the stimulation pulses, determine a response of the patient to the stimulation pulses according to the variation of the biological parameter, and determine a sleep stage of the patient based on the response.

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 active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison.

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 active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison.

Abstract: An active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison.

Abstract: An active implantable medical device provides atrial stimulation for resynchronization of the heart chambers. After a first cycle without stimulation, a premature left atrial stimulation is delivered with application of a short left inter-atrial delay, shorter than the sinus rhythm coupling interval. During the next cycle a non-premature left atrial stimulation is delivered, and the atrioventricular interval between the left atrial depolarization and the ventricular depolarization is evaluated and compared to its value in sinus rhythm to modify as necessary a parameter of the left atrial stimulation, such as the short left inter-atrial delay.

Abstract: A device for treating sleep apnea by discriminating between successive sleep stages of a patient 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, a sensor configured to measure a biological parameter of the patient, and a controller. The controller is configured to determine a state of the patient based on the biological parameter, perform a sleep analysis based on the state of the patient, activate the generator to trigger production of the stimulation pulses, determine a variation of the biological parameter subsequent to the production of the stimulation pulses, determine a response of the patient to the stimulation pulses according to the variation of the biological parameter, and determine a sleep stage of the patient based on the response.

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.

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 active implantable medical device provides atrial stimulation for resynchronization of the heart chambers. After a first cycle without stimulation, a premature left atrial stimulation is delivered with application of a short left inter-atrial delay, shorter than the sinus rhythm coupling interval. During the next cycle a non-premature left atrial stimulation is delivered, and the atrioventricular interval between the left atrial depolarization and the ventricular depolarization is evaluated and compared to its value in sinus rhythm to modify as necessary a parameter of the left atrial stimulation, such as the short left inter-atrial delay.

Abstract: An active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison.

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: 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: An active implantable medical device with atrial pacing for the treatment of diastolic heart failure. This device comprises circuits and leads for collecting right and left atrial events (16,18) and pacing the left atrium (18) and a sensor detecting myocardium contractions, preferably an endocardial acceleration sensor (20), delivering a signal representative of the myocardium contractions. Analysis of the signal allows a determination of the presence or absence of a detectable left atrial contraction distinguishable from the ventricular contraction. An interatrial delay is applied between the collection of a right atrial depolarization and the delivery of a left atrial pacing pulse. In the absence of left atrial contraction, the interatrial delay is iteratively reduced in successive cardiac cycles from an initial value to an adjustment value ensuring that a left atrial contraction appears, and then so maintained while the presence of a left atrial contraction continues.

Abstract: An active implantable medical device for cardiac resynchronization therapy with effort based rate-responsive pacing is described. The device calculates a rate-responsive stimulation frequency based on output signal of an effort sensor between a base frequency (fbase) and a maximum frequency (fmax). The device determines a target stimulation frequency based on the difference between a first frequency and the maximum frequency (fmax). The first frequency is the higher frequency of the base frequency (fbase) and the spontaneous frequency of the patient. The device calculates a stimulation frequency that has an immediate increase in the pacing rate from the higher of the initial value of the current stimulation frequency, or the spontaneous frequency to the target stimulation frequency, within a predetermined time, or a predetermined number of cardiac cycles. A plurality of consecutive effort zones (Z1-Z4) is defined over the extent of the dynamic range of the output signal of the effort sensor.

Abstract: An active implantable medical device with atrial pacing for the treatment of diastolic heart failure. This device comprises circuits and leads for collecting right and left atrial events (16,18) and pacing the left atrium (18) and a sensor detecting myocardium contractions, preferably an endocardial acceleration sensor (20), delivering a signal representative of the myocardium contractions. Analysis of the signal allows a determination of the presence or absence of a detectable left atrial contraction distinguishable from the ventricular contraction. An interatrial delay is applied between the collection of a right atrial depolarization and the delivery of a left atrial pacing pulse. In the absence of left atrial contraction, the interatrial delay is iteratively reduced in successive cardiac cycles from an initial value to an adjustment value ensuring that a left atrial contraction appears, and then so maintained while the presence of a left atrial contraction continues.

Abstract: Sensing ventricular noise artifacts in an active implantable medical device for pacing, resynchronization and/or defibrillation of the heart. This device concerns sensing heart rhythm through an endocardial electrode collecting the depolarization potentials, and detecting the myocardium contractions through an endocardial acceleration sensor. The device searches for ventricular noise artifacts (X, Y) by correlating the signals representative of successive ventricular and atrial depolarizations (P, R) with the signals representative of successive acceleration peaks (PEA I). In case of a lack of correlation, a signal of suspicion of ventricular noise is delivered, which temporarily modifies the sensing sensitivity (S) of the sensing circuit.

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: An active implantable medical device such as a cardiac prosthesis for the treatment of a heart failure by controlled adjustment of the atrioventricular and interventricular delays. The device provides atrioventricular and/or biventricular stimulation, a sensor delivering at least one hemodynamic parameter correlated with time intervals representative of the succession of the systolic and diastolic phases, and circuits to adjust the AV delay and/or VV delay. The device determines (12) during one cardiac cycle several parameters such as the left ventricular pre-ejection interval LPEI, the left ventricular ejection time LVET, the diastolic filling time FT and the conduction time PR. The device compares (14, 18) these parameters with at least one predetermined criterion. If a condition is met, the device readjusts (16) the AV delay and/or VV delay to maximize the ventricular filling and ejection.