Sorin Crm Sas

Ela Medical S.a.s.

Institut National De La Sante Et De La Recherche Medicale

Université De Rennes 1

Université Joseph Fourier

Université Joseph Fourier - Grenoble 1

Ela Medical S.a.

Université De Bretagne Occidentale

Centre Hospitalier Régional Et Universitaire De Brest

Universite Rennes 1

Université Grenoble Alpes

Inserm (institut National De La Sante Et De La Recherche Medicale)

Amel Amblard

Marcel Limousin

Alfredo Hernandez

Laurence Graindorge

Jean-Louis Pépin

Christine Henry

Delphine Feuerstein

Lionel Giorgis

Laure Duchemin Laporte

Fabrizio Renesto

Elodie Vincent

Jérôme Dumont

Rémi Dubois

Sylvain Christophle-Boulard

Gérard Dreyfus

Benoit Hallier

Jacques Mansourati

Charles-Henri Cappelaere

Pierre Roussel

Benoît Hallier

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

Device for discrimination of stages of a patient's sleep

A system includes a processor configured to generate stimulation control signals in response to a detection of a respiratory disorder. The system further includes at least one kinesthetic effector with a vibrating electromechanical transducer applied to a site on a patient's skin for delivering a kinesthetic stimulation energy determined by the control signals. The processor is further configured to determine the effectiveness of a stimulation by detecting a cessation of the respiratory disorder. The processor is further configured to extend the stimulation control signals for a determined duration following the cessation of the respiratory disorder.

System for respiratory disorder therapy with stabilization control of stimulation

A device includes a processor configured to detect a respiratory disorder episode and generate kinesthetic stimulation control signals in response to the detection of a respiratory disorder episode. The device further includes at least one kinesthetic effector adapted to be applied to a patient's outer skin site and includes a vibrating electromechanical transducer capable of receiving stimulation control signals and outputting a kinesthetic stimulation energy determined by the stimulation control signals. The processor is further configured to determine the effectiveness of stimulation by detecting a cessation of the respiratory disorder episode. The processor is further configured to determine a stimulation energy by selecting an initial energy value and varying the energy value as a function of the effectiveness of previous stimulation.

Device for optimization of sleep apnea syndrome therapy by kinesthetic stimulation

A system includes a processor configured to generate stimulation control signals in response to a detection of a respiratory disorder. The system further includes at least one kinesthetic effector with a vibrating electromechanical transducer applied to a site on a patient's skin for delivering a kinesthetic stimulation energy determined by the control signals. The processor is further configured to determine the effectiveness of a stimulation by detecting a disappearance of the respiratory disorder. The processor is further configured to determine a therapy by selecting a stimulation strategy among several stimulation strategies according to a type of expected or detected disorder.

System for respiratory disorder therapy with selection of stimulation strategies

A device for treating sleep apnea in a patient through stimulation. The device includes a generator configured to produce stimulation pulses, a stimulator that receives the stimulation pulses produced by the generator and delivers stimulation to the patient, and a controller. The controller is configured to determine a sleep state of the patient, adaptively control the generator based on the sleep state where the sleep state includes a plurality of sleep stages, and modulate a stimulation energy of the stimulation pulses produced by the generator based on the sleep stage of the patient.

Device for the treatment of sleep apnea syndrome in a patient by kinesthetic stimulation

The invention relates to an active implantable pacemaker. The device analyzes a ventricular electrogram signal (EGM) and is able to recognize, in a search window, an EA4 component of endocardial acceleration (EA) associated with atrial activity. In the presence of atrioventricular conduction, the search window is determined based on the temporal position of the EA1 and/or EA2 components of the EA signal. In the absence of atrioventricular conduction, a delay is counted from a paced ventricular event and applied to mask the EA1 and/or EA2 components in the EA signal, and the window for research of the EA4 component follows the masking delay. In the presence of a confirmed EA4 component, an atrioventricular delay is applied, counted from the EA4 component, and in the opposite case a predetermined escape interval is applied, counted from the last stimulated ventricular event.

Pacemaker with detection of atrial activity without collection of atrial electrical activity

The system includes an active medical device with means for delivering defibrillation shocks; means for continuous collection of the patient current cardiac activity parameters; and evaluator means with neuronal analysis comprising a neural network with at least two layers. This neural network comprises upstream three neural sub-networks receiving the respective parameters divided into separate sub-groups corresponding to classes of arrhythmogenic factors; and downstream an output neuron coupled to the three sub-networks and capable of outputting an index of risk of ventricular arrhythmia. The risk index is compared with a given threshold, to enable or disable at least one function of the device in case of crossing of the threshold.

Neural network system for the evaluation and the adaptation of antitachycardia therapy by an implantable defibrillator

An active implantable medical device includes digital processor circuits configured to sense right and left atrial depolarizations and deliver left atrial stimulation pulses according to a stimulation protocol. The stimulation protocol includes delivering a left atrial stimulation pulse at an inter-atrial coupling interval. The inter-atrial coupling interval is a coupling interval shorter than the sinus rhythm coupling interval, so as to deliver a premature pulse. The protocol further includes delivering a not premature left-atrial stimulation pulse during an immediately subsequent cardiac cycle, at an inter-atrial coupling interval corresponding to the sinus rhythm coupling interval. The protocol also includes assessing the right atrial coupling interval between the right atrial depolarizations and comparing the right atrial coupling interval to the sinus rhythm coupling interval. And finally, modifying an adjustable controlling parameters if necessary according to the result of the comparison. The device has no means for collecting and analyzing the endocardial acceleration.

Active implantable medical device for atrial stimulation for the treatment of heart failure with preserved ejection fraction

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

Active implantable medical device with dual chamber pacing for the treatment of heart failure with preserved ejection fraction

A processor-based method for use with an active implantable medical device for cardiac pacing, resynchronization, and/or defibrillation includes forming a plurality of first and second endocardial acceleration vectors using a plurality of endocardial acceleration signals acquired using stimulation to cause capture and a spontaneous rhythm of the patient in the absence of ventricular pacing, respectively. An at least two dimension space is created using the first and second endocardial acceleration vectors, including two subspaces corresponding to the presence and absence of capture, respectively. Ventricular capture is tested for after acquiring a new endocardial acceleration signal. The testing includes forming a new endocardial acceleration signal based on the new vector. Presence or absence of capture is determined for the new signal based on the position of the new vector relative to the two subspaces.

Ventricular capture testing by analysis of an endocardial acceleration signal in an active implantable medical device

An active implantable medical device such as a cardiac prosthesis, including ventricular capture testing by analysis of an endocardial acceleration signal. The device isolates in an endocardial acceleration ('EA') signal an EA component, extracts from it, n representative indicators (PEA_i, LEA_i), and forms a vector EA (X_i) from these indicators. A classifier allows acquiring reference EA signals at a stimulation energy level sufficient to cause a capture, and in spontaneous rhythm in the absence of ventricular pacing and forms a corresponding plurality of first reference EA vectors. The n-dimensional space of the EA vectors is partitioned into two corresponding subspaces. The presence or absence of a capture is discriminated based on the position of the current EA vector (X_i) in one or other of these two sub-spaces. The representative indicators may be: the value of peak to peak amplitude, the width, the moment of occurrence of the peak, the starting time and the ending time of the EAand/or EAcomponents, the signal to noise ratio (SNR), the contrast value, the entropy value, and the cumulative energy of the EAand/or EAcomponent, or the value of the peak-to-peak amplitude of the EAcomponent.

Detecting a lead fracture in an active implantable medical device for pacing, resynchronization and/or defibrillation of the heart. This device senses the heart rhythm through an endocardial lead comprising at least one endocardial electrode collecting the depolarization potentials, and detecting the myocardium contractions through an endocardial acceleration sensor. The device detects an incipient or total lead fracture by correlating the signals representative of successive ventricular and/or atrial depolarizations (P, R) with the signals representative of successive acceleration peaks (e.g., PEA I). In the case of a lack of correlation, a signal of suspicion of lead fracture is delivered, notably to generate an alarm signal through recording of markers in a memory of the device readable by an external programmer, RF transmission and/or production of an audible signal.

Detecting a lead fracture in an active implantable medical device for cardiac pacing resynchronization cardioversion and/or defibrillation

An active implantable medical device, such as a pacemaker, cardioverter and/ or defibrillator of AAI or AAI/DDD type, with detection of ventricular tachycardiae. This device senses spontaneous ventricular and atrial events; delivers atrial pacing pulses; and is able to apply, after delivery of an atrial pacing pulse, concurrently with sensing ventricular events, a refractory period (PR) and a safety window (FS) of predetermined durations; and determining the beginning of a spontaneous ventricular cycle in response to sensing of a ventricular event out of the safety window (R, R, R, R). It further includes detecting ventricular tachycardiae in response to sensing of ventricular events occurring both within and out of the safety window, conditioned notably by the detection of a sequence of events including, between two consecutive atrial pacing pulses (A, A; A, A), one ventricular event occurring within the safety window (r; r) and one subsequent ventricular event occurring out of the safety window (R, R).

Detection of ventricular tachycardia in an active implantable medical device having an AAI operating mode

An active implantable medical device of the AAI/DDD type, notably a cardiac pacemaker, including automatic mode adjustment at implantation. The device detects spontaneous atrial and ventricular events, and is able to pace the atrium and ventricle. The device can operate in an AAI mode with ventricular sensing, a DDD mode, and includes automatic mode commutation, able to schedule, as a function of predetermined criteria, commutation from AAI to DDD mode, and reversely from DDD to AAI. The device automatically detects an implantation and has its initial mode of operation adjusted upon detection of the implantation (). The device temporarily operates () in an AAI mode with activation of the means for mode commutation, then analyzes () the atrio-ventricular conduction so as to detect whether a potential conduction disorder exists. In case of a potential conduction disorder existing (presence) (), the device is then set to a DDD mode and the automatic mode commutation is inhibited. Otherwise (), the device is set to an AAI mode, and the automatic mode commutation remains activated.

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Sceaux, France

Amel Amblard