Abstract: A method of determining desynchronization between a first implantable medical device and a second implantable medical device. The method includes receiving a synchronization query from the first device at the second device, that is transmitted in response to the first device detecting a predetermined transition of a first clock of the first device, the first clock having a first pulse rate. The method further includes determining a number of pulses of a second clock of the second device occurring between reception of the synchronization query and a predetermined transition of a third clock of the second device, the third clock having the first pulse rate. The second clock has a second pulse rate higher than the first pulse rate. The method further includes determining the desynchronization between the first device and the second device based on the determined number of pulses of the second clock.

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 component including at least one active element hermetically encapsulated in a cavity formed between a support and a cover, in which the support and the cover are made from an electrically conductive material, and are insulated electrically from one another, and include a first electrical connection between the active element and the support, and a second electrical connection, separate from the first connection, between the active element and the cover, and in which: the active element is securely attached to the support through a dielectric layer positioned between the support and the active element, and between the support and the cover; the second electrical connection includes a second portion of electrically conductive material electrically connected to the cover, positioned on the dielectric layer and electrically in contact with an electrically conductive sealing bead providing hermetic secure attachment of the cover to the support.

Abstract: A method of determining desynchronization between a first implantable medical device and a second implantable medical device. The method includes receiving a synchronization query from the first device at the second device, that is transmitted in response to the first device detecting a predetermined transition of a first clock of the first device, the first clock having a first pulse rate. The method further includes determining a number of pulses of a second clock of the second device occurring between reception of the synchronization query and a predetermined transition of a third clock of the second device, the third clock having the first pulse rate. The second clock has a second pulse rate higher than the first pulse rate. The method further includes determining the desynchronization between the first device and the second device based on the determined number of pulses of the second clock.

Abstract: A method for quantification of the desynchronization between the clocks of two medical devices communicating wirelessly, for example, by HBC signals. The devices are separately clocked by slow clocks (CLK1/32k, CLK2/32k) and include selectively activated fast clocks (CLK1/10M, CLK2/10M). The method comprises: a) on a predetermined transition (T1) of a slow clock, transmission by one device of a synchronization query signal (SYNC) to the other device, b) counting of the pulses of the activated fast clock to detect a predetermined transition (T3) of the first slow clock, then c) transmitting from the other device to the first device a response signal (D1) and d) upon reception of the response signal, computing a temporal shift (OFFSET) according to the result (D1, D2) of the counting of the pulses of the fast clock. Two fast clocks, one on each device, also can be used.

Abstract: A component including at least one active element hermetically encapsulated in a cavity formed between a support and a cover, in which the support and the cover are made from an electrically conductive material, and are insulated electrically from one another, and include a first electrical connection between the active element and the support, and a second electrical connection, separate from the first connection, between the active element and the cover, and in which: the active element is securely attached to the support through a dielectric layer positioned between the support and the active element, and between the support and the cover; the second electrical connection includes a second portion of electrically conductive material electrically connected to the cover, positioned on the dielectric layer and electrically in contact with an electrically conductive sealing bead providing hermetic secure attachment of the cover to the support.

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 active implantable medical device having wireless communication of data via electrical pulses conducted by the interstitial tissues of the body. This device (12, 14) includes a pair of electrodes (22, 24) and generates pulse trains consisting of a series of electrical pulses applied to the electrodes. The pulse train is modulated by digital information (data) that is produced by the device. A regulated current or voltage source (42) is used to generate (44, 48) current or voltage pulses to form the pulse train. Each current or voltage pulse is a biphasic pulse comprising a positive and negative alternation. The biphasic current or voltage modulated by the digital information, is injected between the electrodes (22, 24) and wirelessly communicated.

Abstract: A method for quantification of the desynchronization between the clocks of two medical devices communicating wirelessly, for example, by HBC signals. The devices are separately clocked by slow clocks (CLK1/32k, CLK2/32k) and include selectively activated fast clocks (CLK1/10M, CLK2/10M). The method comprises: a) on a predetermined transition (T1) of a slow clock, transmission by one device of a synchronization query signal (SYNC) to the other device, b) counting of the pulses of the activated fast clock to detect a predetermined transition (T3) of the first slow clock, then c) transmitting from the other device to the first device a response signal (D1) and d) upon reception of the response signal, computing a temporal shift (OFFSET) according to the result (D1, D2) of the counting of the pulses of the fast clock. Two fast clocks, one on each device, also can be used.

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: Apparatus for telemetry equipment for communication with an active device implanted in the thoracic area of a patient This equipment includes a wave collector (16) essentially sensitive to a magnetic field so as to allow an exchange of signals through magnetic coupling (i.e., an inductive channel) with the implanted device (14). The wave collector is connected to an electronic circuit package (24) for transmission/reception and signal processing of acquired data and programming. The apparatus further comprises a cloth (10) in the form of a vest to be worn by and able to cover at least one part of the patient's anatomy, a support structure (18) for receiving and supporting the wave collector, and adjustable members able to fix the support structure at a chosen location of the cloth, for example, by means of hooking tapes (20) disposed on the support (18) and cooperating surface material on the cloth.

Abstract: An active medical device able to discriminate between tachycardias of ventricular origin and of supra-ventricular origin. Two distinct temporal components (UnipV, BipV) are obtained corresponding to two EGM signals of ventricular electrograms. The diagnosis operates in at least two-dimensional space to determine, from the variations of one temporal component as a function of the other temporal component, a 2D characteristic representative of a heart beat and, this, for a reference beat collected in Sinus Rhythm (SR) in the absence of tachycardia episodes, and for a heart beat in Tachycardia. The discrimination of the tachycardia type, VT or SVT, is then realized by a classifier operating a comparison of the two current and reference 2D characteristics.

Abstract: An active implantable medical device with RF telemetry comprising subcutaneous ECG electrodes. The case (12) of the device comprises electrodes (20, 22, 24, 26) for collecting subcutaneous ECG signals coming into contact with the patient's tissues surrounding the case after implantation, as well as an RF telemetry antenna (30). These ECG electrodes are surface electrodes and the RF antenna is a surface antenna. The case (12) presents a significantly planar face (16) for mounting the ECG electrodes in an arrangement where these electrodes are significantly coplanar and spaced apart with each other, and receiving the surface RF antenna. A platelet (18) mounted onto the case comprises an insulating substrate comprising on its free face, conductive deposits (20, 22, 24, 26, 30) forming the ECG electrodes and the RF antenna.

Abstract: An active implantable medical device having wireless communication of data via electrical pulses conducted by the interstitial tissues of the body. This device (12, 14) includes a pair of electrodes (22, 24) and generates pulse trains consisting of a series of electrical pulses applied to the electrodes. The pulse train is modulated by digital information (data) that is produced by the device. A regulated current or voltage source (42) is used to generate (44, 48) current or voltage pulses to form the pulse train. Each current or voltage pulse is a biphasic pulse comprising a positive and negative alternation. The biphasic current or voltage modulated by the digital information, is injected between the electrodes (22, 24) and wirelessly communicated.

Abstract: An active implantable medical device including bidirectional communications between a generator and sensors or actuators located at the distal extremity of a lead. A lead (14) is connected at its proximal end to a generator (10) and has at the distal end electrodes (38, 42) able to come in contact with surrounding tissues. A two-wire connection (34, 36) connects these electrodes to the generator. The lead incorporates transducers (24, 26) of sensor or actuator type. The generator includes circuits for sending and receiving digital data (46,48,50,54,56) capable of producing instructions to one of the transducers and to receive and decode information from one of the transducers in response to a specific instruction produced by the generator. The transducer is able to receive, decode and carry out the aforementioned controls, as well as send data in response.

Abstract: The reconstruction of a surface electrocardiogram based upon an endocardial electrogram. This method includes: (a) acquisition (10) of a plurality of endocardial electrogram signals (EGM) through a plurality of endocardial leads defined based upon endocardial electrodes; (b) calculation (12), by combining the endocardial electrogram (EGM) signals acquired at step (a), of the corresponding endocardial vectogram (VGM); (c) angular rescaling (14) of the orthonormalized mark of the endocardial vectogram (VGM) with that of the surface vectocardiogram (VCG); (d) estimation (16), based upon the endocardial vectogram (VGM) calculated at step (b), of a reconstructed surface vectocardiogram (VCGreconstructed), and (e) calculation (18) of the surface electrocardiogram (ECG) corresponding to said reconstructed surface vectocardiogram (VCGreconstructed).

Abstract: The reconstruction of a surface electrocardiogram based upon an endocardial electrogram. This method includes: (a) acquisition (10) of a plurality of endocardial electrogram signals (EGM) through a plurality of endocardial leads defined based upon endocardial electrodes; (b) calculation (12), by combining the endocardial electrogram (EGM) signals acquired at step (a), of the corresponding endocardial vectogram (VGM); (c) angular resealing (14) of the orthonormalized mark of the endocardial vectogram (VGM) with that of the surface vectocardiogram (VCG); (d) estimation (16), based upon the endocardial vectogram (VGM) calculated at step (b), of a reconstructed surface vectocardiogram (VCGreconstructed), and (e) calculation (18) of the surface electrocardiogram (ECG) corresponding to said reconstructed surface vectocardiogram (VCGreconstructed).

Abstract: An active medical device able to discriminate between tachycardias of ventricular origin and of supra-ventricular origin. Two distinct temporal components (UnipV, BipV) are obtained corresponding to two EGM signals of ventricular electrograms. The diagnosis operates in at least two-dimensional space to determine, from the variations of one temporal component as a function of the other temporal component, a 2D characteristic representative of a heart beat and, this, for a reference beat collected in Sinus Rhythm (SR) in the absence of tachycardia episodes, and for a heart beat in Tachycardia. The discrimination of the tachycardia type, VT or SVT, is then realized by a classifier operating a comparison of the two current and reference 2D characteristics.

Abstract: An active implantable medical device having an RF telemetry circuit. The device is in particular a stimulation, resynchronization, defibrillation and/or cardioversion device. It includes a principal circuit, an RF telemetry auxiliary circuit and a supply battery for the principal and auxiliary circuits. It is envisaged to have between the supply battery and the auxiliary circuit a regulating circuit including an accumulator of electric power coupled with the auxiliary circuit to deliver a current ready to feed the auxiliary circuit, and a load circuit coupled with the supply battery to maintain the accumulator on a predetermined level of load.

Abstract: Adjusting the maximum ventricular stimulation frequency according to the hemodynamic state of the patient in an active implantable medical device. This device provides for limiting ventricular stimulation to a maximum frequency (Fmax), the rate of delivery of the stimulation pulses, measuring an intracardiac bio-impedance (Zn, Zn+1), and adjusting the maximum frequency according to the measured intracardiac bio-impedance. The adjusting process can include evaluating a parameter representative of the cardiac flow (dn, dn+1) utilizing the intracardiac signal of bio-impedance; controlling a predetermined variation (X %) of the frequency (f) of delivery of the stimulation pulses; evaluating the correlative variation (y %) of the cardiac flow; and adjusting the value of the maximum frequency (Fmax) according to the variation of the cardiac flow thus evaluated.