This invention relates to a method and system for determining and/or tracking a heart function of a patient. wherein the heart function is estimated by combining information representative of an electrical, mechanical and/or hemodynamic heart function received from imaging, therapy and/or diagnosis systems or a patient database with real-time information representative of an electrical, mechanical and/or hemodynamic heart function received from a measuring device attached or implanted to the patient. The information and the real-time information from can be associated to update an evaluation of the heart function of the patient in real-time and thereby improve the heart function and possibly optimize its efficiency.
A61B 5/02 - Détection, mesure ou enregistrement en vue de l'évaluation du système cardio-vasculaire, p. ex. mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin
A61B 5/0215 - Mesure de la pression dans le cœur ou dans les vaisseaux sanguins par des moyens introduits dans le corps
A61B 5/349 - Détection de paramètres spécifiques du cycle de l'électrocardiogramme
A61B 5/352 - Détection des crêtes de l'onde R, p. ex. pour la synchronisation d'appareils de diagnosticEstimation de l’intervalle entre crêtes R
A61M 60/178 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient implantables dans ou sur le cœur, ou autour du cœur prélevant le sang d’un ventricule et renvoyant le sang vers le système artériel par une canule externe au ventricule, p. ex. dispositifs d’assistance pour ventricule gauche ou droit
A61M 60/196 - Pompes ou dispositifs de pompage implantables, c.-à-d. que le sang est pompé à l’intérieur du corps du patient remplaçant l’ensemble du cœur, p. ex. cœurs artificiels totaux
A61M 60/216 - Pompes pour le sang à déplacement non positif comportant un élément rotatif agissant sur le sang, p. ex. un impulseur
A61M 60/403 - Détails concernant l’entraînement des pompes pour le sang à déplacement non positif
A61M 60/515 - Régulation par des données du patient en temps réel
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
The invention relates to a pacing device (e.g., leadless capsule) that comprises a distal fixation helix for fixing the pacing device at a patient's tissue, wherein the fixation helix comprises an expandable portion that extends when the fixation helix is screwed into the tissue, to thereby reduce the space required during insertion and allow a placement of the pacing device in a bent state for minimal unwanted mechanical interaction.
The invention relates to a lead device with improved puncturing capability and reliability. The proposed structure, shape and dimensions of a tip of the lead device are configured to enable a controlled and smooth puncturing process through the septum or other tissue at the target area with high reliability and longevity. A fixed helix is provided to facilitate handling and an additional screwing sty let with screwdriver functionality may be provided to improve torque transfer to the tip of the lead device for better control of a puncturing process.
The present invention relates to a fixation tool for clamping and rotating a lead terminal pin of a medical implantable cardiac lead. The fixation tool comprises a handle portion and a jaw portion, wherein opposing inner surfaces of a pair of jaws of the jaw portion are shaped to form a cavity system between the pair of jaws, the cavity system comprising a first cavity located proximal to an opening at the distal end of the jaw portion and having a first width between the opposing inner surfaces and being shaped to clamp a first lead terminal pin of a first diameter, and a second cavity located proximal to the first cavity and having a second width between the opposing inner surfaces, smaller than the first width and adapted to clamp, together with the first cavity, a second lead terminal pin of a second diameter larger than the first diameter.
The invention relates to a multi-electrode lead device that comprises an interelectrode portion between a distal first electrode and a proximal second electrode, wherein the interelectrode portion comprises an elongated surface electrode for right bundle branch pacing, the elongated surface electrode having a reduced exposed area and at least one non-exposed portion to obtain an increased current density, wherein the elongated surface electrode is connected to a single pacing input terminal of a proximal lead connector. The elongated surface electrode with reduced exposed area enables lower energy consumption by achieving the increased current density and provides an enhanced right bundle branch pacing area for various anatomies.
The invention relates to a multi-electrode lead device that comprises an interelectrode portion between a distal first electrode and a proximal second electrode, wherein the interelectrode portion comprises two or more additional surface electrodes ("directional" surface electrodes) having a reduced circumferential width for directional pacing and arranged in an axial sequence to obtain an elongated right bundle branch pacing area. Therefore, there is no need for multiple lead models for different anatomies and/or pre- operation examination to measure the septum wall thickness. Moreover, the pacing direction and thus the pacing efficiency of the additional directional surface electrodes can be optimized/adjusted by rotating the lead device around its longitudinal axis.
The invention relates to a lead device that comprises a lead tip with a distal fixation helix for fixing the lead tip at a patient's tissue (e.g., cardiac tissue, in particular tissue of the septum) wherein the fixation helix comprises a cutting portion for cutting the tissue in a circumferential direction of the fixation helix, in addition to a puncturing by a distal tip of the fixation helix (30), when the fixation helix is screwed into the tissue, to support longitudinal insertion of the lead tip with the fixation helix into the tissue. Thereby, insertion and longitudinal advancement of the lead tip into the tissue can be facilitated and smoothened due to a pre-cutting of the tissue in a circumferential direction at and/or around and/or within the fixation helix during the screwing operation into the tissue.
The present invention relates to a fixation tool for clamping and rotating a lead terminal pin of a medical implantable cardiac lead. The fixation tool comprises a handle portion and a jaw portion, wherein opposing inner surfaces of a pair of jaws of the jaw portion are shaped to form a cavity system between the pair of jaws, the cavity system comprising a first cavity located proximal to an opening at the distal end of the jaw portion and having a first width between the opposing inner surfaces and being shaped to clamp a first lead terminal pin of a first diameter, and a second cavity located proximal to the first cavity and having a second width between the opposing inner surfaces, smaller than the first width and adapted to clamp, together with the first cavity, a second lead terminal pin of a second diameter larger than the first diameter.
System for characterizing a cardiac rhythm, configured to implement, by computer, the following steps: ■ generating an input vector, the components of the input vector comprising, among indicators of sets of indicators of probability of presence only each indicator of probability of presence of a selection, ■ generating, using a global classifier, global indicators of probability of presence of arrhythmias in a time window from the input vector, the system comprising a selector making it possible to select and/or deselect at least one of the indicators of probability of presence such that the selection is composed of each indicator of probability of presence selected.
122) of the probability of the presence of the arrhythmia in the time window by using a classifier using values of the set of at least one derivation, - generating indicators of the probability of the presence of the arrhythmia in the time window by using a second classifier using first portions including a portion preceding the R-wave, combinations of second beat portions of the set of at least one derivation, - generating indicators of the probability of the presence of the arrhythmia in the time window by using a classifier using a set of statistical indicators representative of the distribution of R-R intervals.
The invention relates to a lead device with improved puncturing capability and reliability. The proposed structure, shape and dimensions of a tip of the lead device are configured to enable a controlled and smooth puncturing process through the septum or other tissue at the target area with high reliability and longevity. A fixed helix is provided to facilitate handling and an additional screwing stylet with screwdriver functionality may be provided to improve torque transfer to the tip of the lead device for better control of a puncturing process.
The invention relates to a screwing stylet for improving torque transfer from a physician's hand to a lead tip (e.g., helix) of a lead device. A lead tip is provided to facilitate handling and a screwdriver functionality of the screwing stylet is provided to improve torque transfer to the lead tip of the lead device for better control of a puncturing process. The screwing stylet can be engaged directly with the tip of the lead device, thereby allowing a direct and efficient torque transfer to the fixed helix at the tip.
The present invention relates to a step-up converter with a plurality of levels, in particular for use in an implantable medical device, comprising a transformer (11) comprising a single primary winding and a single secondary winding; a primary circuit (6) comprising the single primary winding; and a secondary circuit (7) comprising the single secondary winding and a plurality of step-up levels, each of the step-up levels comprising a first diode (4a, 4b, 4c, 4d, 4e, 4f) and a second diode (10a, 10b, 10c, 10d, 10e, 10f) and a first capacitor (9a, 9b, 9c, 9d, 9e, 9f) and a second capacitor (3a, 3b, 3c, 3d, 3e, 3f), wherein the first capacitors (9a, 9b, 9c, 9d, 9e, 9f) of the plurality of step-up levels are connected in series or in parallel with one another. The present invention also relates to an implantable medical device comprising the step-up converter with a plurality of levels mentioned above, and a method for using the step-up converter with a plurality of levels or the implantable device mentioned above.
H02M 3/00 - Transformation d'une puissance d'entrée en courant continu en une puissance de sortie en courant continu
H02M 3/335 - Transformation d'une puissance d'entrée en courant continu en une puissance de sortie en courant continu avec transformation intermédiaire en courant alternatif par convertisseurs statiques utilisant des tubes à décharge avec électrode de commande ou des dispositifs à semi-conducteurs avec électrodes de commande pour produire le courant alternatif intermédiaire utilisant des dispositifs du type triode ou transistor exigeant l'application continue d'un signal de commande utilisant uniquement des dispositifs à semi-conducteurs
14.
DEVICE FOR MONITORING OPERATION OF A PROBE OF AN IMPLANTABLE ACTIVE CARDIAC DEVICE
A device for monitoring operation of a probe of an implantable active cardiac device, in particular an implantable automatic defibrillator or a defibrillator for cardiac resynchronization. The device comprising a parameter-determining device for determining values of a plurality of parameters characterizing the probe, and a processing unit configured to determine representative values that are representative of at least one parameter of the plurality of parameters characterizing the probe based on at least two different time scales. The processing unit is further configured to compare an analysis value of the at least one parameter of the plurality of parameters characterizing the probe with the representative values of the at least one parameter.
The present invention relates to an implantable pacing and/or defibrillation lead (10, 100, 200) wherein the electrical connection between active fixation electrode (22, 26, 126) and a distal housing portion (122, 222) of the lead (10, 100. 200) is realized by means of an electrically conductive compression spring (176, 276) is at least partially radially arranged around a tubular body (138, 238) of a guiding member (35, 136, 236) and a radial opening (158, 258) of the guiding member (136, 236), such that the electrically conductive compression spring (176, 126) is forced by its restoring force against a conductive driver shaft (120, 220) mechanically and electrically connected to the active fixation electrode (126, 226).
An assembly comprising an implanting accessory, and a stimulation lead. The lead configured to be combined with an active implantable medical device and implanted through a right ventricular free wall. The implanting accessory comprising a needle with a free puncturing end, where at least a first portion of the lead is configured to be inserted into an inner lumen of the needle. In a state where the first portion of the lead is inserted into the inner lumen, the first portion of the lead comprises at least a first branch that extends from the lead in a direction oriented toward the free puncturing end, the first branch extending from the lead from a junction point arranged a predetermined distance from a distal end of the lead, the predetermined distance corresponding to a second portion of the lead between the junction point and the distal end of the lead.
A method of communication in a system comprising plurality of implantable medical devices, where a first device comprises a means for detection of a signal representative of atrial activity, a transmitter, and a controller, and a second device independent of the first device, the second device comprising a receiver and a controller. The method comprises synchronizing the first device with the second device, determining the duration of a cardiac cycle, determining a synchronization interval, the duration of the synchronization interval determined as a function of the duration of the cardiac cycle, the synchronization interval being shorter than the duration of the cardiac cycle, and the start of the synchronization interval is determined as a function of the synchronization signal, and activating the receiver of the second device during the synchronization interval, wherein the receiver of the second device is deactivated outside of the synchronization interval.
A cardiac defibrillation system. The system comprising a housing and an implantable lead. The implantable lead comprising two ends, including a first end connected to the housing and a second end being a free end. The implantable lead also comprising a defibrillation electrode and at least three detection electrodes including a first detection electrode, a second detection electrode, and a third detection electrode. The first detection electrode and the second detection electrode forming a first dipole. The third detection electrode and the first detection electrode, or, the third detection electrode and the second detection electrode, or, the housing and one of said detection electrodes, forming a second dipole, where a length of the first dipole is between 5 and 50 millimeters and a length of the second dipole is between 50 and 400 millimeters.
This invention relates to a method and system for determining and/or tracking a heart function of a patient, wherein the heart function is estimated by combining information representative of an electrical, mechanical and/or hemodynamic heart function received from imaging, therapy and/or diagnosis systems or a patient database with real-time information representative of an electrical, mechanical and/or hemodynamic heart function received from a measuring device attached or implanted to the patient. The information and the real-time information from can be associated to update an evaluation of the heart function of the patient in real-time and thereby improve the heart function and possibly optimize its efficiency.
A communication system for enabling a writing operation in a memory of an implantable medical device. The communication system includes an intermediate proximity device configured to receive writing data transmitted by a main writing device, the intermediate proximity device configured to communicate with the implantable medical device. The system also includes a first external unlocking tool configured to transmit a detectable signal when the first external unlocking tool is located within a predetermined perimeter of the implantable medical device, where the intermediate proximity device is configured to cause the implantable medical device to write the writing data into the memory of the implantable medical device when the first external unlocking tool is in the predetermined perimeter of the implantable medical device.
The present invention relates to a step-up converter with a plurality of levels, in particular for use in an implantable medical device, comprising a transformer (11) comprising a single primary winding and a single secondary winding; a primary circuit (6) comprising the single primary winding; and a secondary circuit (7) comprising the single secondary winding and a plurality of step-up levels, each of the step-up levels comprising a first diode (4a, 4b, 4c, 4d, 4e, 4f) and a second diode (10a, 10b, 10c, 10d, 10e, 10f) and a first capacitor (9a, 9b, 9c, 9d, 9e, 9f) and a second capacitor (3a, 3b, 3c, 3d, 3e, 3f), wherein the first capacitors (9a, 9b, 9c, 9d, 9e, 9f) of the plurality of step-up levels are connected in series or in parallel with one another. The present invention also relates to an implantable medical device comprising the step-up converter with a plurality of levels mentioned above, and a method for using the step-up converter with a plurality of levels or the implantable device mentioned above.
H02M 3/335 - Transformation d'une puissance d'entrée en courant continu en une puissance de sortie en courant continu avec transformation intermédiaire en courant alternatif par convertisseurs statiques utilisant des tubes à décharge avec électrode de commande ou des dispositifs à semi-conducteurs avec électrodes de commande pour produire le courant alternatif intermédiaire utilisant des dispositifs du type triode ou transistor exigeant l'application continue d'un signal de commande utilisant uniquement des dispositifs à semi-conducteurs
H02M 7/10 - Transformation d'une puissance d'entrée en courant alternatif en une puissance de sortie en courant continu sans possibilité de réversibilité par convertisseurs statiques utilisant des tubes à décharge sans électrode de commande ou des dispositifs à semi-conducteurs sans éléctrode de commande agencés pour la marche en série, p. ex. pour la multiplication de tension
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
The present invention relates to an implantable pacing and/or defibrillation lead (10, 100, 200) wherein the electrical connection between active fixation electrode (22, 26, 126) and a distal housing portion (122, 222) of the lead (10, 100. 200) is realized by means of an electrically conductive compression spring (176, 276) is at least partially radially arranged around a tubular body (138, 238) of a guiding member (35, 136, 236) and a radial opening (158, 258) of the guiding member (136, 236), such that the electrically conductive compression spring (176, 126) is forced by its restoring force against a conductive driver shaft (120, 220) mechanically and electrically connected to the active fixation electrode (126, 226).
The present invention relates to an assembly consisting of an implanting accessory comprising a needle (13) and of a flexible implantable stimulation probe. In a state in which a first portion (24) of the probe (14) is inserted into the lumen (17) of the needle (13), said first portion (24) of the probe (14) comprises at least one first branch (26) which extends from the probe body (16) in a direction (D) oriented towards the pointed free end (15) of the needle (13), the first branch (26) extending from the probe body (16) at a predetermined distance (L1) from the distal end (22), said distance corresponding to a second portion (28) of the probe body (16) between the first branch (26) and the distal end (22) of the probe (14),
The present invention relates to a device for monitoring operation of a probe of an implantable active cardiac device, in particular an implantable automated defibrillator or a defibrillator for cardiac resynchronisation, comprising a parameter-determining device for determining values of a plurality of parameters characterising the probe, a processing unit configured to determine values representative of at least one parameter of the plurality of parameters characterising the probe on at least two different timescales, the processing unit furthermore being configured to compare a value, called the analysis value, of at least one parameter of the plurality of parameters characterising the probe with the values representative of said parameter.
The present disclosure relates to an implantable lead comprising an elongated lead body having at least one lumen therein and at least one through hole, and at least one electrically conductive wire. For at least one of said at least one lumen, a first through hole extends from an outer surface of the lead body into said lumen, and an electrically conductive wire is arranged in said lumen at least on one side of said first through hole. Furthermore, said electrically conductive wire is further arranged in a configuration exiting the lumen via said first through hole and wound around a predefined portion of the outer surface of the lead body.
The present invention relates to a wireless communication method and a multi-device system configured to implement said method for adjusting and adapting communication windows to a patient's electrophysiological rhythm. Each device in the system is configured to determine a time marker (Pref1 n, Pref2 n) associated with the detection of a PQRST complex wave and to rearrange the communication window in accordance with the time marker thus determined for each cardiac cycle.
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
G16H 20/30 - TIC spécialement adaptées aux thérapies ou aux plans d’amélioration de la santé, p. ex. pour manier les prescriptions, orienter la thérapie ou surveiller l’observance par les patients concernant des thérapies ou des activités physiques, p. ex. la physiothérapie, l’acupression ou les exercices
G16H 40/60 - TIC spécialement adaptées à la gestion ou à l’administration de ressources ou d’établissements de santéTIC spécialement adaptées à la gestion ou au fonctionnement d’équipement ou de dispositifs médicaux pour le fonctionnement d’équipement ou de dispositifs médicaux
27.
Active implantable medical device for detecting and quantifying fusion
Disclosed are systems, devices and methods that produce at least two distinct temporal components from two distinct endocardial electrogram (EGM) signals collected concurrently, determines a non-temporal 2D characteristic representative of the cardiac cycle to be analyzed, from the variations of one of the temporal components as a function of another of the temporal components and comparing the characteristic of the current cycle to two reference characteristics previously obtained and stored, one in a situation of complete capture and the other in a situation of spontaneous rhythm. Respective values of similarity descriptors are derived of these two comparisons, which are used to calculate a metric quantifying a fusion rate.
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
The disclosure relates to a multipolar, detection/stimulation endovascular lead intended to be implanted in the coronary venous network. The lead comprises a lead body with in proximal portion a connector to a cardiac pacemaker/defibrillator generator, and in a distal portion a first branch and a second branch extending beyond a bifurcation. The distal ends of the branches are free ends carrying an array of electrodes connected to the connector. Each of the branches comprises at its free end an outlet in the distal direction, able to receive an implantation guide wire inserted therein and to guide the implantation guide wire in an axial direction parallel to the main axis of the lead body.
An implantable medical system includes at least four electrodes forming a dipole emitter and a dipole receiver which is distinct from the dipole emitter. The system is configured to recover physiological mechanical information by way of the two dipoles, by analyzing a received and processed electrical signal, wherein the amplitude has been modulated in accordance with the electrical properties of the propagation medium between the dipole emitter and the dipole receiver. Thus, a parameter which is representative of a pre-ejection period may be extracted from the attenuation of the voltage between the dipole emitter and the dipole receiver by taking an electrocardiogram or an electrogram into account.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61B 5/287 - Supports pour électrodes multiples, p. ex. cathéters à électrode pour des études électrophysiologiques [EEP]
A61B 5/29 - Électrodes bioélectriques à cet effet spécialement adaptées à des utilisations particulières pour l’électrocardiographie [ECG] invasives pour implantation permanente ou à long terme
A61B 5/318 - Modalités électriques se rapportant au cœur, p. ex. électrocardiographie [ECG]
A method for determining usable capacity of a battery of an active implantable medical device comprising a radiofrequency (RF) communication unit for transmitting data by RF over a communication period, wherein the usable capacity of the battery enables the active implantable medical device to transmit data by RF via the RF communication unit. The method includes measuring a value for the voltage of the battery which is representative of an instantaneous voltage drop of the battery as a result of a current draw on the battery, comparing the voltage of the battery with a predetermined threshold voltage VBS, and transmitting an alert message to a second device when the measured voltage of the battery crosses the predetermined threshold voltage.
The present invention relates to a system of multiple implantable medical devices for an impedance measurement comprising a first implantable medical device, at least a second implantable medical device distinct from the first implantable medical device and; an analysis module comprising at least one amplifier and one envelope detector, one of the first implantable medical device or the second implantable medical device being a subcutaneous implantable cardioverter defibrillator or a subcutaneous loop recorder, and the other of the first implantable medical device or the second implantable medical device being an implantable endocardial device.
An implantation accessory includes a steerable catheter comprising, on a distal end, a tubular protection tip having an internal lumen configured to house an implantable medical device. The tubular protection tip includes a fastening mechanism comprising an elastic deformable component that engages a rigid component disposed within a cavity of the implantable medical device to secure the implantable medical device within the tubular protection tip. The elastic deformable component can provide radial compression about the rigid component, and application of a torsion torque to the tubular element during implantation of the implantable medical device causes the elastic deformable component to release the rigid component.
A torque limiter for a delivery system of a leadless active implantable medical device includes a first interface for coupling to a docking feature of the delivery system, the docking feature secured in rotation with respect to the leadless active implantable medical device and a second interface for coupling to a distal end of a torque shaft of the delivery system, the torque limiter limiting the torque transmission from the torque shaft to the docking feature when radial torque is applied to the torque shaft.
An active implantable medical device includes a detection electrode and a pulse generator. The pulse generator is configured to collect via the detection electrode at least two EGM signals, combine the EGM signals into two time components, and combine the components into a single 2D parametric characteristic representing the cardiac cycle. During a tachyarrhythmia episode, the device measures stores values of a cycle-to-cycle variation in an amplitude of the at least one of the EGM signals, distributes the amplitude variation values into a plurality of classes, each class corresponding to an amplitude interval, and analyzes a size of each of the plurality of classes to deliver at least one of an indicator of suspicion of an artifact of extracardiac origin or an indicator of a type of tachyarrhythmia selectively as a function of at least one predetermined criterion applied to the distribution of the amplitude variation values.
This disclosure relates to a communication amplification device for an implantable capsule, in particular for an autonomous cardiac stimulation capsule. The amplification device comprises a first holding element and a second element configured to hold the implantable capsule. The first holding element is configured to receive the distal end of the capsule and the second holding element is configured to receive the proximal end of the capsule. The first holding element comprises a communication amplification antenna configured to couple to a distal electrode of the capsule.
An implantation accessory for an intracardiac capsule includes a catheter with a catheter body and a tubular protection tip disposed at a distal end of the catheter body. The tubular protection tip includes a flexible portion disposed between a base portion structured to couple the tubular protection tip to the catheter body and a cylindrical portion structured to house the intracardiac capsule.
A subcutaneous lead for an implantable cardiac device, in particular for a defibrillator or/and a pacemaker comprising a lead body, itself comprising at least one sensing electrode and an insulating sleeve into which the lead body is threaded so that the insulating sleeve and the lead body are movable relative to each other so as to at least partially cover the at least one sensing electrode with the insulating sleeve.
A subcutaneous implantable active medical device, in particular a subcutaneous cardiac defibrillator, comprising a housing and a subcutaneous implantable lead connected to the housing. The subcutaneous implantable lead comprises a plurality of sensing electrodes forming at least two dipoles from which at least two electrical signals are collected concurrently. The first dipole having a first length less than a second length of the second dipole. The subcutaneous implantable active medical device further comprises a controller configured to determine whether or not tachyarrhythmia is present by determining a criterion of similarity based on the electrical signals collected concurrently via the first dipole and via the second dipole during a defined series of cardiac cycles that is such that detection of a depolarization peak, corresponding to detection of an R wave, is performed via the first dipole.
A subcutaneous cardiac defibrillation system implantable comprising a housing and a subcutaneous implantable lead comprising a proximal end connected to the housing and a distal free end. The subcutaneous implantable lead comprises at least one defibrillation electrode and at least three detection electrodes. The first detection electrode and the second detection electrode form a first dipole, and the third detection electrode and the first detection electrode, or the third detection electrode and the second detection electrode, or the housing and one of said detection electrodes, form a second dipole. The defibrillation electrode is positioned between the second detection electrode and the third detection electrode, the first dipole is positioned between the housing and the defibrillation electrode, the third electrode is positioned between the free distal end of the lead and the defibrillation electrode, and the length of the first dipole is shorter than the length of the second dipole.
A system and method for extra cardiac defibrillation is disclosed. In a particular embodiment, an extra cardiac implantable cardioverter defibrillator system includes an implantable defibrillator having a metal case and a defibrillation lead. The defibrillation lead has a connector at its proximal end for coupling to the implantable defibrillator and a first defibrillation coil electrode at a distal portion of the lead. The first defibrillation electrode configured to be disposed in an inferior vena cava.
An assembly including an autonomous capsule having an anchoring member adapted to penetrate tissue of the heart and an accessory for implantation of the capsule. The accessory includes a steerable catheter with an inner lumen, having at its distal end a tubular protection tip defining a volume for housing the capsule. The accessory also includes a disconnectable attachment mechanism for supporting and guiding the capsule to an implantation site and a sub-catheter housed within the lumen of the steerable catheter, moveable in translation and in rotation relative to the steerable catheter. The sub-catheter and the capsule are movable between a retracted position and a position wherein the capsule is deployed out of the protection tip. The sub-catheter and the capsule are provided with a first fastening mechanism for fastening the two in translation and in mutual rotation, which is disconnectable under a rotation applied to the sub-catheter.
This system includes a conductor microcable and an insulating microcatheter, including a hollow tube housing the microcable with the possibility of relative axial translation therebetween. The microcatheter is suitable for permanent implantation. The microcatheter, in its distal portion, includes at least one lateral window formed by a through orifice formed on the wall of the hollow tube. The window forms a stimulation site defined on the wall of the target vein facing the window of the microcatheter, and provides for a region of the microcable surface located at the window to form a stimulation electrode. In its distal portion, the microcable is not isolated at least in the region of the window of the microcatheter. The microcatheter is telescopically moveable on the microcable, so as to modify the position of the stimulation site of the target vein.
The present disclosure relates to an implantable medical device, in particular a cardiac defibrillator, comprising an implantable defibrillator configured to generate an electrical defibrillation signal, an implantable electrode connected with the implantable defibrillator by a lead and configured to deliver the electrical defibrillation signal to a patient, an implantable sensor configured to detect mechanical vibrations by the heart of the patient and to provide a detection signal based on the detected mechanical vibrations, and a controller configured to analyze the detection signal to determine at least one parameter characterizing the mechanical vibrations and to initiate a defibrillation operation of the implantable defibrillator based on the determined parameter characterizing the mechanical vibrations.
The present invention relates to a medical device, in particular to an implantable medical device, comprising at least one implantable or non-implantable hemodynamic sensor configured for detecting hemodynamic cardiac signals, a controller configured for processing and analyzing the detected cardiac hemodynamic signals or signals derived from the detected cardiac hemodynamic signals by applying to said signals a Teager Energy Operator (TEO). The controller further comprises at least one algorithm configured to determine the need for a defibrillation operation by taking into account the at least one output hemodynamic signal. The present invention also provides a method and software for detecting or treating a ventricular fibrillation episode by taking into account cardiac hemodynamic signals.
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
The present invention relates to a system and a method for improving the security of an operation for writing the memory of an active implantable medical device by long distance telemetry, in particular via network connection with a writing main device. The system and method according to the present invention comprise an intermediate proximity device allowing communication between the active implantable medical device and the main writing device and at least one unlocking tool allowing access to the active implantable medical device.
The present invention relates to an implantable lead comprising at least one conductive wire and one electrical connector, the electrical connector configured to be connected to an implantable medical device such as a cardiac stimulation, defibrillation and/or neuromodulation device, wherein the electrical connection between the conductive wire and the connector is effected by a first hypotube welded to the conductive wire and welded to a second hypotube of the electrical connector. The present invention also relates to a method for electrically connecting the at least one conductive wire of the implantable lead to the electrical connector.
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
The present invention relates to an implantable lead comprising at least one conductive wire and a connector. The connector is configured to be connected to an implantable medical device, such as a cardiac stimulation, a defibrillation or/and a neuromodulation device, and further comprising a strain relief device extending longitudinally along an axis from one end of the connector and essentially parallel to the longitudinal axis of the connector. The conductive wire is deflected by a deflection wall of the strain relief device such that the deflection wall of the strain relief device blocks the conductive wire against the deflection wall when the conductive wire is stressed in tension, and the deflection wall extends along an axis which is misaligned with the longitudinal axis of the strain relief device.
Leads for use with implantable medical devices may be implanted in the venous, arterial, or lymphatic networks. The diameter of a microlead may be at most equal to 1.5 French (0.5 mm), and it may include a plurality of micro-cables each including: an electrically conductive core cable for connection to one pole of a multipolar generator of an active implantable medical device, and a polymer insulation layer surrounding the core cable. At least one exposed area may be formed in the insulation layer to form a detection/stimulation electrode.
According to some embodiments, a device operates by comparative morphological analysis of depolarization signals collected in spontaneous rhythm on separate respective channels, with two temporal components combined into a single 2D parametric VGM vectogram characteristic. Similarity quantification methods evaluate a variation over time of a descriptor parameter of a current VGM compared to a stored previous reference VGM. This variation is compared with predetermined thresholds to diagnose an occurrence of remodeling or reverse remodeling in a patient, and/or to detect a lead failure or an occurrence of ischemia. The descriptor parameter is a function of a velocity vector of the VGM, a comparison relating to a correlation coefficient between respective magnitudes of a current VGM velocity vector and of a reference VGM velocity vector, and an average angle between these respective velocity vectors.
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
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.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61B 5/287 - Supports pour électrodes multiples, p. ex. cathéters à électrode pour des études électrophysiologiques [EEP]
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
52.
Connection method for connecting an isolated micro-conductor
The present invention relates to a method for connecting a strand of a multi-strand cable to an electrode of an implantable medical device. The method includes cutting a strand of the multi-strand cable lifting at least one of the free ends, stripping the end of the lifted strand, placing an electrode around the multi-strand cable to partially cover the end of the lifted and stripped stand, and connecting at least one portion of the stripped end of the strand to the electrode.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
H01R 4/18 - Connexions conductrices de l'électricité entre plusieurs organes conducteurs en contact direct, c.-à-d. se touchant l'un l'autreMoyens pour réaliser ou maintenir de tels contactsConnexions conductrices de l'électricité ayant plusieurs emplacements espacés de connexion pour les conducteurs et utilisant des organes de contact pénétrant dans l'isolation effectuées uniquement par torsion, enroulage, pliage, sertissage ou autre déformation permanente par sertissage
53.
Explantation accessory for an intracorporeal capsule
An explantation accessory includes a catheter with a steerable head carrying a tubular receptacle adapted to accommodate the proximal portion of the capsule. The explantation accessory further includes a lasso having a flexible wire extending along the catheter to and forming at its distal end a deformable loop. One end of the deformable loop is mobile so as to allow tightening of the loop under the effect of a traction exerted on the flexible wire along the catheter. The free end edge of the tubular receptacle comprises a protruding anterior portion, an axially recessed posterior portion with respect to the anterior portion and located diametrically opposite to the protruding anterior portion, and two beveled edges connecting the protruding anterior portion to the recessed posterior portion.
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
54.
Device for electrochemically releasing a composition in a controlled manner
According to a first aspect, the invention relates to a device (10) for electrochemically releasing a composition and comprising: one working electrode (30) comprising an electroactive conjugated polymer (40) containing or doped with said composition, a counter electrode (50), and a reference electrode (60). The device (10) is characterized in that it comprises electrical means (95, 100; 320; 165, 180) connected to the working electrode (30) and to the counter electrode (50) for obtaining at said working electrode (30) at least one composition releasing sequence (65) with respect to said reference electrode (60), each composition releasing sequence (65) comprising: a first voltametric pulse (70), followed by a rest period (80) during which no current is able to flow through said working electrode (30), followed by a second voltametric pulse (90), followed by an intermediate period (160) during which no current is able to flow through said working electrode (30).
C25B 15/02 - Commande ou régulation des opérations
C25B 9/00 - Cellules ou assemblages de cellulesÉléments de structure des cellulesAssemblages d'éléments de structure, p. ex. assemblages d'électrode-diaphragmeCaractéristiques des cellules relatives aux procédés
A61N 1/30 - Appareils d'ionothérapie ou d'électrophorèse
An active implantable medical device includes a VNS pulse bursts generator for stimulation of the vagus nerve according to several selectable configurations. The device may further include a sensor of the current activity level of the patient. The generator is controlled on the activity signal via a classifier determining the class of the current level of activity among a plurality of classes of activity. A controller selects a configuration of VNS therapy depending on the class of activity thus determined. Limits of the activity classes are dynamically changeable by a calibration module that conducts a historical analysis of the successive current activity levels over a predetermined analysis period. The calibration module can prepare a histogram of the historical analysis, and can define the limits of the activity classes depending on the outcome of the historical analysis and the histogram.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
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.
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
The disclosure relates to a multipolar, detection/stimulation endovascular lead intended to be implanted in the coronary venous network. The lead comprises a lead body with in proximal portion a connector to a cardiac pacemaker/defibrillator generator, and in a distal portion a first branch and a second branch extending beyond a bifurcation. The distal ends of the branches are free ends carrying an array of electrodes connected to the connector. Each of the branches comprises at its free end an outlet in the distal direction, able to receive an implantation guide wire inserted therein and to guide the implantation guide wire in an axial direction parallel to the main axis of the lead body.
A method of manufacturing a lead. The method includes providing a supporting tube, and disposing a conductive strip on an outer surface of the supporting tube such that the conductive strip extends in an axial direction along a length of the supporting tube. The method also includes mounting a chip having a first conductive contact pad and a second conductive contact pad to the supporting tube such that the first conductive contact pad is in contact with the conductive strip. The method further includes fitting an electrode to the supporting tube such that the electrode is in contact with the second conductive contact pad, and coupling a conductor to each end of the supporting tube such that each conductor is in contact with the conductive strip. The method also includes covering at least one of the chip and the conductors with a sheath to provide the lead.
H01R 43/20 - Appareils ou procédés spécialement adaptés à la fabrication, l'assemblage, l'entretien ou la réparation de connecteurs de lignes ou de collecteurs de courant ou pour relier les conducteurs électriques pour assembler les pièces de contact avec le socle isolant, le boîtier ou le manchon ou pour les en désassembler
INSERM—INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE (France)
Inventeur(s)
Bonnet, Jean-Luc
Hernandez, Alfredo
Carrault, Guy
Romero, Hector
Abrégé
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.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
This disclosure relates to active implantable medical devices. Some such devices include a pulse generator and at least one detection electrode. A processor of the pulse generator is configured to collect via the detection electrode at least two EGM signals, combine the EGM signals into two time components, and combine the components into a single 2D parametric characteristic representing the cardiac cycle. During a tachyarrhythmia episode, the device stores the consecutive values of the cycle-to-cycle variation in the amplitude of one EGM signal, distributes same into a plurality of classes each corresponding to an amplitude interval, and performs a statistical analysis of the totals for each class so as to output, selectively, on the basis of at least one predetermined criterion applied to the distribution of the amplitude variations into the various classes, an indicator of a suspected extracardiac artifact or an indicator of tachyarrhythmia.
A device which includes a generator of electric current pulses and a neurostimulation probe with M sectoral electrodes forming stimulation poles for passing a current between at least one anode and at least one cathode in a predetermined stimulation configuration. The generator includes N current sources and N current sinks, the N sources and the N sinks being defined independently of the M electrodes. A first distribution circuit can indiscriminately and dynamically switch any of the N sources to any of the M electrodes, and a second distribution circuit can indiscriminately and dynamically switch any of the N sinks to any of the M electrodes. The device can thus define a plurality of commutation combinations between sources and/or sinks, providing a single average current in the organ to be stimulated for different respective predetermined pole configurations.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/02 - ÉlectrothérapieCircuits à cet effet Parties constitutives
62.
Implantable lead for electrical stimulation and/or for collecting electrical potentials on an organ, incorporating a passive component function
This disclosure relates to an implantable lead for electrical stimulation of an organ and/or for collecting electrical potentials on this organ. The lead comprises a distal termination able to come into contact with the tissues of an organ, the termination comprising an insulating substrate and at least one conductive interface carried by the substrate. The lead further comprises a lead body having at least one bonding conductor connected to a respective conductive interface. The conductive interface comprises at least one deformable conductive wire with a woven, embroidered, braided or knitted configuration for anchoring the deformable wire to the substrate.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61B 5/24 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
H05K 1/03 - Emploi de matériaux pour réaliser le substrat
H05K 3/10 - Appareils ou procédés pour la fabrication de circuits imprimés dans lesquels le matériau conducteur est appliqué au support isolant de manière à former le parcours conducteur recherché
63.
Explantation assembly for retrieving intracorporeal autonomous capsules
The present disclosure relates to an explantation assembly for retrieving an intracorporeal capsule implanted in a tissue of a patient comprising a first tube and a second tube. The first tube comprises a snare and a tissue. The second tube is configured to interact with the snare of the first tube and configured to be attached to the tissue of the patient.
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
The present disclosure relates to an implantable lead comprising an elongated lead body having at least one lumen therein and at least one through hole, and at least one electrically conductive wire. For at least one of said at least one lumen, a first through hole extends from an outer surface of the lead body into said lumen, and an electrically conductive wire is arranged in said lumen at least on one side of said first through hole. Furthermore, said electrically conductive wire is further arranged in a configuration exiting the lumen via said first through hole and wound around a predefined portion of the outer surface of the lead body.
The present disclosure relates to an electrical connector cap, in particular for an implantable lead, the electrical connector cap comprising an elongated body having at least one lumen and at least one through hole extending from an outer surface of the elongated body into the lumen, and at least one electrically conductive member arranged on an outer circumference of the elongated body over said at least one through hole of the elongated body. Furthermore, said at least one electrically conductive member comprises at least one through hole (extending from an outer surface of the electrically conductive member into the lumen through said at least one through hole of the elongated body. The disclosure further relates to implantable lead assemblies comprising said electrical connector cap, and to an implantable lead member usable with said electrical connector cap.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
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.
A61B 5/055 - Détection, mesure ou enregistrement pour établir un diagnostic au moyen de courants électriques ou de champs magnétiquesMesure utilisant des micro-ondes ou des ondes radio faisant intervenir la résonance magnétique nucléaire [RMN] ou électronique [RME], p. ex. formation d'images par résonance magnétique
67.
Implantable probe comprising a sleeve, particularly for the stimulation of a nerve, and manufacturing method for said sleeve
The present invention relates to an implantable probe comprising a sleeve adapted to be wound around an elongated cylindrical organ, such as a vagus nerve. The sleeve comprises a sheet of elastically deformable material carrying a detection/stimulation electrode being prestressed so as to allow its self-winding from an initial position where the sheet is held under stress in the deployed state to a final position where the sheet is freely spirally wound forming a sleeve around the organ. The sheet is delimited by inner and outer lateral edges of the sleeve after winding, a first transverse edge joining the first homologous ends of the first lateral edge and the second lateral edge, and a second opposite transversal edge joining homologous second ends of the first lateral edge and the second lateral edge. In the final position of the sleeve, the sheet comprises at least one area having a constraint near the first and/or second transverse edge.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
68.
Active implantable medical device such as a cardiac resynchroniser with dynamic adaptation of an atrioventricular delay depending on a detected and quantified degree of fusion
This disclosure relates to an active implantable medical device of the cardiac resynchronizer type. The device includes a pulse generator to produce pacing pulses, at least one detection electrode for detecting atrial and ventricular events, at least one stimulation electrode, a memory storing executable instructions, and a processor configured to execute the instructions. The processor is configured to execute the instructions to apply an atrioventricular delay (AVD) between a sensed or stimulated atrial event and the delivery of a ventricular pacing pulse, quantify a degree of fusion between the delivery of a pacing pulse to a cavity and a spontaneous contraction of another cavity, calculate a fusion rate, and modify the value of the AVD applied to the delivery of said ventricular pacing pulse, as a function of a comparison.
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
The present invention relates to an implantable cardiac device. The implantable cardiac device comprises a planar spiral for attaching the implantable cardiac device to a patient's tissue.
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.
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.
A61N 1/372 - Aménagements en relation avec l'implantation des stimulateurs
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A metal ring for installation as an electrode on a microcable includes an elongated ring having an internal lumen, a middle portion partially collapsed into the internal lumen and adapted to puncture a sheath of the microcable when the middle portion is crimped around the microcable, and two end portions surrounding the middle portion.
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.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61B 5/24 - Détection, mesure ou enregistrement de signaux bioélectriques ou biomagnétiques du corps ou de parties de celui-ci
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
This disclosure relates to an active medical device which includes a generator for producing multiphase nerve stimulation pulse trains, each pulse train including at least one stimulation pulse preceded by a precharge pulse and ending with a passive discharge pulse. The active medical device also includes a sensor configured to output a control signal representative of a physiological and/or physical parameter capable of being influenced by the output of nerve stimulation pulse trains. The active medical device also includes an automatic charge compensation control circuit configured to receive at the input the control signal output by the sensor, determine an amplitude and/or a precharge pulse time as a function of at least one predetermined criterion, and output to the generator a precharge pulse control signal to be produced at the output.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/02 - ÉlectrothérapieCircuits à cet effet Parties constitutives
A61N 1/08 - Aménagements ou circuits de surveillance, de protection, de commande ou d'indication
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.
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61B 5/042 - Electrodes spécialement adaptées à cet effet pour l'introduction dans le corps
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
The disclosure relates to implantable probes. An implantable probe includes a sleeve capable of being wound around an elongate organ of cylindrical shape, and includes a sheet of elastically deformable material that supports at least one electrode. The sheet is prestressed in such a way as to allow it to self-wind from an initial position, in which the sheet is kept stressed in the deployed state, to a final position, in which the sheet is wound freely in a spiral to form a sleeve around the organ, with the first face, which supports the electrodes, being directed towards the inside. The sheet is delimited by an outer lateral edge of the sleeve after winding, an inner lateral edge of the sleeve after winding, and a first transverse edge and a second, opposite transverse edge. The sheet includes perforations located in proximity to the first and/or second transverse edge.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
77.
Implantable cardiac resynchronizer with biventricular pacing and detection of loss of capture and anodal stimulation
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.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
78.
Active implantable medical device that can perform a frequential analysis
INSERM—INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE (France)
UNIVERSITE DE RENNES 1 (France)
Inventeur(s)
Bonnet, Jean-Luc
Herrmann, Thomas
Henry, Christine
Hernandez, Alfredo
Carrault, Guy
Abrégé
The invention relates to an active implantable medical device comprising a processing unit able to be alternately operated during a predetermined period of activity and on standby during a standby period in a cyclical manner, and means for acquiring data relating to physiological and/or physical activity. The device also comprises means for calculating a frequency analysis of the data acquired, said calculating means being capable of successively perform part of the frequency analysis during periods of activity of the processing unit.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
G16H 40/40 - TIC spécialement adaptées à la gestion ou à l’administration de ressources ou d’établissements de santéTIC spécialement adaptées à la gestion ou au fonctionnement d’équipement ou de dispositifs médicaux pour la gestion d’équipement ou de dispositifs médicaux, p. ex. pour planifier la maintenance ou les mises à jour
G06F 1/3206 - Surveillance d’événements, de dispositifs ou de paramètres initiant un changement de mode d’alimentation
G06F 1/3287 - Économie d’énergie caractérisée par l'action entreprise par la mise hors tension d’une unité fonctionnelle individuelle dans un ordinateur
G06F 1/329 - Économie d’énergie caractérisée par l'action entreprise par planification de tâches
G16H 50/20 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le diagnostic assisté par ordinateur, p. ex. basé sur des systèmes experts médicaux
A61B 5/0245 - Mesure du pouls ou des pulsations cardiaques utilisant des capteurs engendrant des signaux électriques
A61B 5/08 - Dispositifs de mesure pour examiner les organes respiratoires
A61B 5/11 - Mesure du mouvement du corps entier ou de parties de celui-ci, p. ex. tremblement de la tête ou des mains ou mobilité d'un membre
A61B 5/024 - Mesure du pouls ou des pulsations cardiaques
79.
Coupling system between a medical device and implantation accessory
An assembly includes a medical device provided with an anchoring member adapted to penetrate tissue of a cavity of the heart. The assembly further includes an implantation accessory including an elongated tubular element provided with a fastening mechanism for handling and guiding the medical device to an implantation site. The fastening mechanism includes an elastic deformable component cooperating with a rigid component, that is able to disconnect the medical device from the tubular element under the effect of a rotation exerted to the tubular element. The elastic deformable component cooperates with the rigid component such that the elastic deformable component exerts on the latter a radial constriction effect, and the elastic component and the rigid component being disconnected under the combined effect of a torsion torque and a traction exerted to the elastic deformable component, to thereby reduce the radial constriction until release of the rigid component.
The disclosure relates to a method of manufacturing an implantable defibrillation coil for a lead of an active implantable medical device, the defibrillating coil includes at least one elongate conductive coil which includes a plurality of non-contiguous turns. The method includes inserting a tube of polymeric material within the elongated conductive coil, supplying thermal energy to soften the tube, applying pressure on the assembly formed by the elongate conductive coil and causing the tube to deform the tube wall by insertion of the tube wall between the turns of the elongate conductive coil.
The disclosure relates to a lead including a connector for connection to a generator, a demultiplexing circuit receiving at its input on the first conductors of the electrical control signals from the control bus and whose output is connected to a plurality of second conductors contained in the lead and connected to the lead electrodes. The lead further includes a gate and connection circuit component having a body forming a support for an integrated circuit for demultiplexing and defining a set of connection cavities with the second conductor distributed at the periphery of the body around a general axis of the body, and a plurality of connecting elements embedded in the body material, and emerging at an element region and supporting the circuit at respective cavities. The gate and connection circuit component is advantageously made of ceramic-metal.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/02 - ÉlectrothérapieCircuits à cet effet Parties constitutives
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
H01R 24/86 - Contacts parallèles disposés autour d'un axe commun
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.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/08 - Aménagements ou circuits de surveillance, de protection, de commande ou d'indication
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
83.
Active implantable medical device with dynamic optimization of stimulation pulse energy
The disclosure relates to a device including a circuit for adjusting the energy of the stimulation pulses, independently controlling the pulse width and the voltage of each stimulation pulse. An iterative search algorithm for determining the optimum energy includes changing both the pulse width and voltage at each new pulse delivered, by setting a high energy value and a low energy value, and delivering a stimulation pulse with the low energy value. A capture test is then carried out. In the presence of a capture, a current iteration is complete and a new iteration is done with the current low energy as a new high energy value. In the absence of capture, the algorithm is terminated with selection of the last energy value that produced the capture as the value of optimum energy.
This system includes a conductor microcable and an insulating microcatheter, including a hollow tube housing the microcable with the possibility of relative axial translation therebetween. The microcatheter is suitable for permanent implantation. The microcatheter, in its distal portion, includes at least one lateral window formed by a through orifice formed on the wall of the hollow tube. The window forms a stimulation site defined on the wall of the target vein facing the window of the microcatheter, and provides for a region of the microcable surface located at the window to form a stimulation electrode. In its distal portion, the microcable is not isolated at least in the region of the window of the microcatheter. The microcatheter is telescopically moveable on the microcable, so as to modify the position of the stimulation site of the target vein.
The implant including an elongated tubular body, having at a first end a releasable device connected to an installation lead, and at a second end a member for anchoring to a heart wall, the tubular body housing a frame supporting an electronic unit. The implant further comprises an accelerometer. This accelerometer comprises a piezoelectric blade extending in cantilever from an embedding section of the frame, in a direction going from the first end to the second end.
H02N 2/18 - Machines électriques en général utilisant l'effet piézo-électrique, l'électrostriction ou la magnétostriction fournissant une sortie électrique à partir d'une entrée mécanique, p. ex. générateurs
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
H01L 41/113 - Eléments piézo-électriques ou électrostrictifs à entrée mécanique et sortie électrique
A61N 1/375 - Aménagements structurels, p. ex. boîtiers
The implant including an elongated tubular body, having at a first end a releasable device connected to an installation lead, and at a second end a member for anchoring to a heart wall, the tubular body housing a frame supporting an electronic unit. The implant further comprises an accelerometer. This accelerometer comprises a piezoelectric blade extending in cantilever from an embedding section of the frame, in a direction going from the first end to the second end.
A system and method for extra cardiac defibrillation is disclosed. In a particular embodiment, an extra cardiac implantable cardioverter defibrillator system includes an implantable defibrillator having a metal case and a defibrillation lead. The defibrillation lead has a connector at its proximal end for coupling to the implantable defibrillator and a first defibrillation coil electrode at a distal portion of the lead. The first defibrillation electrode configured to be disposed in an inferior vena cava.
A system and method for extra cardiac defibrillation is disclosed. In a particular embodiment, an extra cardiac implantable cardioverter defibrillator system includes an implantable defibrillator having a metal case and a defibrillation lead. The defibrillation lead has a connector at its proximal end for coupling to the implantable defibrillator and a first defibrillation coil electrode at a distal portion of the lead. The first defibrillation electrode configured to be disposed in an inferior vena cava.
An assembly including an autonomous capsule having an anchoring member adapted to penetrate tissue of the heart and an accessory for implantation of the capsule. The accessory includes a steerable catheter with an inner lumen, having at its distal end a tubular protection tip defining a volume for housing the capsule. The accessory also includes a disconnectable attachment mechanism for supporting and guiding the capsule to an implantation site and a sub-catheter housed within the lumen of the steerable catheter, moveable in translation and in rotation relative to the steerable catheter. The sub-catheter and the capsule are movable between a retracted position and a position wherein the capsule is deployed out of the protection tip. The sub-catheter and the capsule are provided with a first fastening mechanism for fastening the two in translation and in mutual rotation, which is disconnectable under a rotation applied to the sub-catheter.
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.
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A61B 5/042 - Electrodes spécialement adaptées à cet effet pour l'introduction dans le corps
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
91.
Active implantable medical device for detecting a remodeling or reverse remodeling phenomenon of the patient
According to some embodiments, a device operates by comparative morphological analysis of depolarization signals collected in spontaneous rhythm on separate respective channels, with two temporal components combined into a single 2D parametric VGM vectogram characteristic. Similarity quantification methods evaluate a variation over time of a descriptor parameter of a current VGM compared to a stored previous reference VGM. This variation is compared with predetermined thresholds to diagnose an occurrence of remodeling or reverse remodeling in a patient, and/or to detect a lead failure or an occurrence of ischemia. The descriptor parameter is a function of a velocity vector of the VGM, a comparison relating to a correlation coefficient between respective magnitudes of a current VGM velocity vector and of a reference VGM velocity vector, and an average angle between these respective velocity vectors.
A61N 1/365 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque
A61N 1/368 - Stimulateurs cardiaques commandés par un paramètre physiologique, p. ex. par le potentiel cardiaque comprenant plus d'une électrode coopérant avec différentes régions du cœur
A torque limiting mechanism between a medical device and an implantation accessory is disclosed. In a particular embodiment, a delivery system for a leadless active implantable medical device includes a delivery catheter and a torque shaft disposed within the delivery catheter. The delivery system also includes a docking cap having a distal end for engaging an attachment mechanism of the leadless active implantable medical device. The delivery system also includes a torque limiting component coupled to a distal end of the torque shaft and a proximal end of the docking cap.
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.
A torque limiting mechanism between a medical device and an implantation accessory is disclosed. In a particular embodiment, a delivery system for a leadless active implantable medical device includes a delivery catheter and a torque shaft (428) disposed within the delivery catheter. The delivery system also includes a docking cap (416) having a distal end for engaging an attachment mechanism of the leadless active implantable medical device. The delivery system also includes a torque limiting component (424) coupled to a distal end of the torque shaft and a proximal end of the docking cap.
The lead (100) includes a lead body (110) with in proximal portion (120) a connector to a cardiac pacemaker/defibrillator generator, and in distal portion a first branch (130) and a second branch (140) extending beyond a bifurcation (112). The distal ends (134, 144) of the branches are free ends carrying an array of electrodes (136, 136', 146, 146') connected to the connector (120). Each of the branches comprises at its free end a outlet in the distal direction, able to receive an implantation guide wire (210, 230) inserted therein and to guide this implantation guide wire in an axial direction parallel to the main axis of the lead body.
This device comprises an autonomous subcutaneous unit (110) with a leaktight body, incorporating a control circuit for the cardiac rhythm, a control circuit for the respiratory rhythm, and a combined operating circuit for operating the control circuits for cardiac rhythm and respiratory rhythm. It additionally comprises at least one cardiostimulation microprobe (120) with at least one electrode (122) implanted in or on the myocardium, and at least one neurostimulation microprobe (130; 140) with at least one electrode (132; 142) to be implanted on or near a nerve (NPCPG; NPCPD) of the patient. The device overall is in the form of an autonomous hybrid capsule integrating, within one and the same assembly, the autonomous unit (110), the cardiostimulation probe (120) and the neurostimulation probes (130; 140), without an electrical connector between the electronic circuits and the microprobes, and each of the probes is a continuation of the leaktight body of the autonomous unit (110) at one side of the latter.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
The lead comprises a distal termination adapted to come into contact with the tissues of the organ, this termination comprising an insulating substrate (28) and at least one conductive interface carried by the substrate. The conductive interface comprises at least one deformable wire (48) with a woven, embroidered, braided or knitted configuration for anchoring the deformable wire (48) to the substrate (28). This woven, embroidered, braided or knitted configuration comprises a pattern (52, 54) imparting a passive component electrical function (C) to the at least one deformable conductive wire. The passive component may be a resistor, a capacitor, an RF antenna, an inductor, and several of these components may be combined to form devices such as a transformer or a filter.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
A61B 5/04 - Mesure de signaux bioélectriques du corps ou de parties de celui-ci
H05K 1/03 - Emploi de matériaux pour réaliser le substrat
98.
ACTIVE IMPLANTABLE MEDICAL NEUROSTIMULATION DEVICE WITH SECTORAL ELECTRODES THAT ARE SWITCHABLE ACCORDING TO VARIOUS CONFIGURATIONS
The invention relates to a device which includes a generator (10) of electric current pulses and a neurostimulation probe with M sectoral electrodes (24) forming stimulation poles for passing a current between at least one anode (A) and at least one cathode (K) in a predetermined stimulation configuration. The generator (10) includes N current sources (22) and N current sinks (32), the N sources and the N sinks being defined independently of the M electrodes. A first distribution circuit (26) can indiscriminately and dynamically switch any of the N sources to any of the M electrodes, and a second distribution circuit (36) can indiscriminately and dynamically switch any of the N sinks to any of the M electrodes. The device can thus define a plurality of switching combinations between sources and/or sinks, providing a single average current in the organ to be stimulated for different respective predetermined pole configurations.
A61N 1/05 - Électrodes à implanter ou à introduire dans le corps, p. ex. électrode cardiaque
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
99.
ACTIVE IMPLANTABLE MEDICAL DEFIBRILLATION DEVICE, INCLUDING IMPROVED MEANS FOR DISCRIMINATING BETWEEN EXTERNAL NOISE AND PROBE BREAKAGE AND FOR CHARACTERISING TACHYARRHYTHMIAS
The invention relates to a device which picks up two EGM signals over separate respective channels, giving two respective time components. The two time components are combined in a single 2D parametric characteristic representing the cardiac cycle. During a tachyarrhythmia episode, the device stores (104) the consecutive values of the cycle-to-cycle variation in the amplitude of one of said EGM signals, distributes same into a plurality of classes each corresponding to an amplitude interval, and performs (120, 126) a statistical analysis of the totals for each class so as to output, selectively, on the basis of at least one predetermined criterion applied to the distribution of the amplitude variations into the various classes, an indicator of a suspected extracardiac artefact or an indicator of tachyarrhythmia.
The invention relates to an implantable probe comprising a sleeve that can be wound around a long cylindrical body, said sleeve comprising a film (26) consisting of an elastically deformable material carrying at least one detection/stimulation electrode (28). The film is pre-stressed so as to allow the self-winding thereof from an initial position in which the film is maintained under stress in the deployed state to an end position in which the film is freely wound in a spiral forming a sleeve. In the end position of the sleeve, the film (26) comprises at least one zone which is under less stress close to the first and/or second transverse edge on the longitudinal edges, than a zone located in a central region of the film, in such a way as to create at least one end of the opened film. The invention also relates to a method for producing such a sleeve for an implantable probe.
