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Clamart, France

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Clamart, France

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Seoudi I.,Sorin CRM | Amara K.,Sorin CRM | Gayral F.,Sorin CRM | Dal Molin R.,Sorin CRM | Amara A.,Graduate School of Engineers in Paris
2011 18th IEEE International Conference on Electronics, Circuits, and Systems, ICECS 2011 | Year: 2011

Modern pacemakers deliver localized electrical stimuli to the cardiac tissue via electrodes in the stimulation lead. The stimulation lead come either in unipolar or bipolar configuration (1 or 2 electrode). Studies however have shown benefits of a multi-electrode system in rendering therapy for heart diseases like chronic heart failure. In this paper we present the design and implementation of such a multi-electrode system. We discuss and provide solutions as well as the key challenges for such design in a constrained cardiac environment. These challenges are namely, powering of multi-electrode system, the communication protocol and the compliance with the existing standards. Our chip has been fabricated in 0.18 μm technology and occupies 2.25x5.35 mm 2 area. It enables ultra-low power operation down to 1.8 volts and allows quick configuration. Our design has been tested by simulations and measurements. To the best of our knowledge our study is the first published study of its kind. © 2011 IEEE.


MULTICARDE is a Tecsan ANR exploratory project that was launched in 2007 and ended up in 2009. ELA Medical (SORIN Group) and the CEA-Leti were associated for this development. The project aims at enhancing the therapy for congestive heart failure based on biventricular electrical resynchronization therapy. Several studies proved the efficiency of this therapy, which remains subjected to the good positioning of the left pacing lead. The MULTICARDE project develops a programmable multi-electrodes pacing to improve the hemodynamic status of the patient. Multiple constraints must be taken into account for this kind of project, such as the power consumption, the size and the interoperability towards leads' standards. To address these requirements an innovative collective packaging process was developed to integrate electronics inside the lead. © 2010 Elsevier Masson SAS. All rights reserved.


Cinquin P.,French National Center for Scientific Research | Cosnier S.,French National Center for Scientific Research | Belgacem N.,Grenoble Institute of Technology | Cosnier M.L.,CEA Grenoble | And 2 more authors.
Journal of Physics: Conference Series | Year: 2013

An Implantable BioFuel Cell (IBFC) is a device that produces power only from the chemicals that are naturally occurring inside the body. We have been working on two approaches to creating an IBFC. The first approach is to use chemicals such as glucose and oxygen to provide the fuel for an enzymatic IBFC. The second approach is to use electrolytes such as sodium to provide the fuel for a biomimetic IBFC. © Published under licence by IOP Publishing Ltd.


Donal E.,Rennes University Hospital Center | Donal E.,French Institute of Health and Medical Research | Donal E.,University of Rennes 1 | Giorgis L.,French Institute of Health and Medical Research | And 15 more authors.
Europace | Year: 2011

Aims: Optimization of cardiac resynchronization therapy (CRT) requires the gathering of cardiac functional information. An accurate timing of the phases of the cardiac cycle is key in the optimization process. Methods and results: We compared Doppler echocardiography to an automated system, based on the recording of sonR (formerly endocardial acceleration), in the detection of mitral and aortic valves closures and measurements of the duration of systole and diastole. We prospectively studied, under various conditions of cardiac stimulation, 75 recipients of CRT systems (69% men), whose mean age was 72 ± 9.2 years, left ventricular ejection fraction 35 ± 11%, baseline QRS duration 154 ± 29 ms, and New York Heart Association functional class 3.0 ± 0.7. We simultaneously recorded (i) sonR, detected by a non-invasive piezoelectric micro-accelerometer sensor clipped onto an electrode located in the parasternal region, (b) electrocardiogram, and (c) Doppler audio signals, using a multichannel data acquisition and analysis system. The correlation between timing of mitral and aortic valve closure by sonR vs. Doppler signals was examined by linear regression analysis. Correlation coefficients and the average absolute error were calculated. A concordance in the timing of the mitral (r = 0.86, error =9.7 ms) and aortic (r = 0.93, error =9.7 ms) valves closure was observed between the two methods in 94 of patients. Similarly, sonR and the Doppler-derived measurements of systolic (r = 0.85, error =13.4 ms) and diastolic (r = 0.99, error = 12 ms) interval durations were concordant in 80% of patients. Conclusion: A high concordance was found between sonR and the cardiac ultrasound in the timings of aortic and mitral valve closures and in the estimation of systolic and diastolic intervals durations. These observations suggest that sonR could be used to monitor cardiac function and adaptively optimize CRT systems. © The Author 2010.


Poree F.,French Institute of Health and Medical Research | Poree F.,University of Rennes 1 | Kachenoura A.,French Institute of Health and Medical Research | Kachenoura A.,University of Rennes 1 | And 8 more authors.
IEEE Transactions on Biomedical Engineering | Year: 2013

This study proposes a method to facilitate the remote follow up of patients suffering from cardiac pathologies and treated with an implantable device, by synthesizing a 12-lead surface ECG from the intracardiac electrograms (EGM) recorded by the device. Two methods (direct and indirect), based on dynamic time-delay artificial neural networks (TDNNs) are proposed and compared with classical linear approaches. The direct method aims to estimate 12 different transfer functions between the EGM and each surface ECG signal. The indirect method is based on a preliminary orthogonalization phase of the available EGM and ECG signals, and the application of the TDNN between these orthogonalized signals, using only three transfer functions. These methods are evaluated on a dataset issued from 15 patients. Correlation coefficients calculated between the synthesized and the real ECG show that the proposed TDNN methods represent an efficient way to synthesize 12-lead ECG, from two or four EGM and perform better than the linear ones. We also evaluate the results as a function of the EGM configuration. Results are also supported by the comparison of extracted features and a qualitative analysis performed by a cardiologist. © 1964-2012 IEEE.


Deterre M.,CNRS Fundamental Electronics Institute | Risquez S.,CNRS Fundamental Electronics Institute | Bouthaud B.,Sorin CRM | Molin R.D.,Sorin CRM | And 2 more authors.
Journal of Physics: Conference Series | Year: 2013

We present an innovative multilayer out-of-plane electrostatic energy harvesting device conceived in view of scavenging energy from regular blood pressure in the heart. This concept involves the use of a deformable packaging for the implant in order to transmit the blood pressure to the electrostatic transducer. As shown in previous work, this is possible by using thin metal micro-bellows structure, providing long term hermeticity and high flexibility. The design of the electrostatic device has overcome several challenges such as the very low frequency of the mechanical excitation (1 to 2 Hz) and the small available room in the medical implant. Analytical and numerical models have been used to maximize the capacitance variation, and hence to optimize the energy conversion. We have theoretically shown that a 25-layer transducer with 6-mm diameter and 1-mm thickness could harvest at least 20 mJ per heart beat in the left ventricle under a maximum voltage of 75 V. These results show that the proposed concept is promising and could power the next generation of leadless pacemakers. © Published under licence by IOP Publishing Ltd.


Tillocher T.,University of Orléans | Lefaucheux P.,University of Orléans | Boutaud B.,SORIN CRM | Dussart R.,University of Orléans
Journal of Micromechanics and Microengineering | Year: 2014

Titanium is increasingly used as a platform material in microdevices dedicated to biological and bio medical applications. Existing processes for titanium deep etching use a chlorine based chemistry. This paper reports on a low reproducibility for such chemistries when titanium samples are glued onto a silicon carrier wafer. In this case, a SiOCl layer redeposits on the chamber walls as well as on the sample surface. This leads to a decrease of the etch rate and the formation of a very high roughness with a similar morphology as black silicon. The alternated process for the deep etching of titanium (APETi) described in this paper has been designed to improve the overall reproducibility by preventing high roughness formation. It is a time-multiplexed process where Cl2/Ar plasma steps are alternated with SF6 plasma steps. The first step aims at etching with vertical walls (anisotropy) while the second aims at reducing the roughness by removing SiOCl from the sample surface. © 2014 IOP Publishing Ltd.


Milpied P.,Sorin CRM | Milpied P.,ESPCI ParisTech | Dubois R.,ESPCI ParisTech | Roussel P.,ESPCI ParisTech | And 2 more authors.
IEEE Transactions on Biomedical Engineering | Year: 2011

Arrhythmia classification remains a major challenge for appropriate therapy delivery in implantable cardioverter defibrillators (ICDs). The purpose of this paper is to present a new algorithm for arrhythmia discrimination based on a statistical classification by support vector machines of a novel 2-D representation of electrograms (EGMs) named spatial projection of tachycardia (SPOT) EGMs. SPOT-based discrimination algorithm provided sensitivity and specificity of 98.8 and 91.3, respectively, on a test database. A simplified version of the algorithm is also presented, which can be directly implemented in the ICD. © 2010 IEEE.


Banz K.,OUTCOMES International Ltd | Delnoy P.P.,Isala Klinieken | Billuart J.R.,Sorin CRM
Health Economics Review | Year: 2015

Background: Recent studies provide evidence of improved clinical benefits associated with cardiac resynchronization therapy (CRT) optimization. Our analysis explores the cost-effectiveness of systematically optimized (SO, 3 times a year) vs. non-systematically optimized (NSO, less than 3 times a year) CRT, whatever the echo optimization method used (manual or SonR® automatic). A longitudinal cohort model was developed to predict clinical and economic outcomes for SO vs. NSO strategies over 5 years. The analysis was performed from the payer perspective. Data from CLEAR study post-hoc analysis was used with 199 pts with CRT pacemaker (CRT-P). The main economic outcome measure was incremental cost-effectiveness (ICER) expressed as cost per Quality Adjusted Life Years (QALY) gained. To assess the impact of data uncertainty, a sensitivity analysis was performed. The model also predicts outcomes for the two optimization strategies for CRT-D therapy vs. optimal medical treatment (OPT). Results: At 1 year, ICERs for SO CRT vs. NSO CRT-P range between € 22,226 (Spain) and € 26,977 (Italy). Therefore, on the basis of a Willingness-To-Pay of €30,000 per QALY, the SO method develops into a cost effective strategy from 1 year, onwards. These favorable outcomes are supported by the sensitivity analysis. Systematic optimization of CRT-D might also improve the cost-effectiveness of this device therapy by 27 % to 30 % dependent on the country analyzed, at 5 years. Conclusions: Our economic evaluation shows promising health economic benefits associated with SO CRT. These preliminary findings need further confirmation. © 2015, Banz et al.


PubMed | Sorin CRM
Type: Journal Article | Journal: IEEE transactions on bio-medical engineering | Year: 2011

Arrhythmia classification remains a major challenge for appropriate therapy delivery in implantable cardioverter defibrillators (ICDs). The purpose of this paper is to present a new algorithm for arrhythmia discrimination based on a statistical classification by support vector machines of a novel 2-D representation of electrograms (EGMs) named spatial projection of tachycardia (SPOT) EGMs. SPOT-based discrimination algorithm provided sensitivity and specificity of 98.8% and 91.3%, respectively, on a test database. A simplified version of the algorithm is also presented, which can be directly implemented in the ICD.

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