Sorin Crm Sas

Paola Milpied

Marie-Anne Euzen

Christine Henry

Delphine Feuerstein

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.

Active implantable medical device for detecting and quantifying fusion

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.

Active implantable medical defibrillation device

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.

Active implantable medical device for detecting a remodeling or reverse remodeling phenomenon of the patient

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.

Active implantable medical device for the diagnosis of cardiac decompensation

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.

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 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 single-chamber implantable device for detecting a patient's atrial activity using a monobody lead is disclosed. The monobody lead () includes a ventricular coil (), a supraventricular coil (), a distal electrode () forming three electrodes for detecting depolarization signals. A generator () of the implantable device collects a first unipolar signal () between the ventricular coil and the generator housing and a second unipolar signal () between the supraventricular coil and the generator housing. An independent component analysis is performed to the detected depolarization signals to determine an estimated atrial activity signal from the first and second unipolar signals.

Atrial activity signal estimation using independent component analysis

This device includes a sensor of endocardiac acceleration EA and one or more circuits configured for: extracting from the EA signal a predetermined EA parameter, determining a period of sleep, evaluating the clinical condition of the patient based on the EA parameter variations on this sleep period, and issuing an alert of worsening of the patient's condition. The device further determines a variability index of the EA parameter on the sleep period, and then calculates a ratio between this calculated variability index and a reference value, and delivers this ratio as a clinical status index. The alert signal is generated by the crossing by this ratio of a predetermined alert threshold.

Systems and methods for diagnosing heart failure based on sleep apneic indicators

Performing a capture test on a stimulated cardiac cycle based on the analysis of a cardiac vectogram using an active medical device including circuits and control logic for delivering electrical stimulation pulses to a heart chamber; collecting electrical activity of the heart chamber and producing two distinct temporal components (V, V) from two distinct intracardiac electrogram EGM signals from the heart chamber. The capture test detects an occurrence of a depolarization wave induced by the stimulation of the heart chamber, and determines a two-dimensional non-temporal characteristic (VGM) representative of the stimulated cardiac cycle, from the variation of one of the temporal components (V) versus the other temporal component (V). A bi-dimensional analysis delivers at least one descriptor parameter of the two-dimensional non-temporal characteristic, and determines a presence or loss of a capture based on the at least one descriptor parameter.

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Paris, France

Paola Milpied