Sorin Biomedica Cardio S.p.a.

Sorin Biomedica Cardio Crm S.r.l.

Luigi Silvestri

Gianni Plicchi

Guido Gaggini

Bruno Garberoglio

Emanuela Marcelli

Luca Vitali

Laura Vaccarone

A device for determining the effectiveness of the electrical stimulation of heart muscle from a signal having a post-potential component and, with effective stimulation, a superimposed evoked response component. The device includes a differential stage with a first input for application of the signal and a second input for application of a feedback signal. The differential stage generates a corresponding output signal whose level is determined by the levels of the signals present at the first and said second inputs. A comparator stage has feedback units able to act on the second input in a follower relationship with respect to the signal present at the first input avoiding saturation of the differential stage. The feedback units generate at least one compensation signal indicating the variation in the signal present at the first input over time. The compensation signal is indicative of the evoked response superimposed on the post-potential component.

Device for determining the effectiveness of stimulation in an electrical heart stimulator

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

Implantable heart stimulation system with automatic mode switching controlled by sympatho-vagal balance

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Turin, Italy

Luigi Silvestri