Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
  • A61B5/316—Modalities, i.e. specific diagnostic methods
  • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
  • A61B5/346—Analysis of electrocardiograms
  • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
  • A61B5/0031—Implanted circuitry
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
  • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
  • A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
  • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
  • A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
  • A61B5/6871—Stomach
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
  • A61B5/7271—Specific aspects of physiological measurement analysis
  • A61B5/7275—Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
  • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
  • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
  • G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
  • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
  • A61B2562/0219—Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches

Definitions

• the field of the present invention is that of devices for measuring
• Cardiac decompensation can thus lead to cardiogenic edema in the thoracic area, especially in lung tissue. Breathing discomfort and shortness of breath are among the symptoms, induced by compensation of the lungs increasing their work of breathing and causing in particular chest pain. These symptoms worsen to major respiratory distress if the accumulation of fluid is not detected upstream. Pulmonary edema is medically considered to be a life-threatening emergency that must be treated at the first signs, the treatments being heavier the later the diagnosis is, the tissues being less engorged at an initial stage.
• Patients at risk are generally followed by regular medical examinations, such as auscultation by the practitioner, electrocardiogram, blood test and / or chest x-ray in order to identify heart problems.
• regular medical examinations such as auscultation by the practitioner, electrocardiogram, blood test and / or chest x-ray in order to identify heart problems.
• the patient is forced to closely monitor his lifestyle and to treat his cardiac pathology to avoid complications underlying cardiac decompensation.
• the aim of the present invention is therefore to provide a device capable of identifying the beginnings of a state of cardiac decompensation, said device being simple to use and compatible with repeated use for the monitoring and early detection of problems. cardiac conditions in a patient at risk of cardiac decompensation.
• the invention relates to a device for determining information relating to a state of cardiac decompensation of a user, said information being obtained by analysis of a cardiac parameter, characterized in that it comprises at least one device.
• measuring device configured to determine a signal value via at least one user accelerometric signal curve, said signal value being intended to be compared with an additional signal value from a measurement by a monitor cardiac, the measuring device comprising for this purpose at least one accelerometer configured to determine said curve of the user's accelerometric signals, the measuring device being configured to be housed in an implant internal to the user.
• the device according to the invention is particularly advantageous in that it makes it possible to combine a bimodal analysis, taking into account signals
• the electrocardiogram is a graphic representation of the electrical activity of the heart at the origin of its mechanical activity, that is to say its contractions, while the mechanical activity is followed by using the accelerometer.
• Accelerometric and cardiac parameter can be obtained reproducibly and reliably. Indeed, the implantation participates in a fixed position of the accelerometer embedded in the implant, and at the very least in a stable position measurement after measurement.
• the measuring device includes the accelerometer which generates the curve of accelerometric signals. This curve of accelerometric signals is intended to be compared with other data, in this case a
• the accelerometer measures acceleration along at least one axis.
• the accelerometer is for example an accelerometer with one to three axes orthogonal to each other.
• accelerometer corresponds to a positive peak on the curve of accelerometric signals, indicating a maximum of the opening of the aortic valve of the user known as "aortic amplitude".
• the onset of the signal is a time marker in determining the cardiac parameter.
• the determining device comprises a measuring device configured to measure the value of the additional signal, this measuring device comprising at least the heart monitor, the determining device further comprising a measuring device. calculation configured to determine a value of the cardiac parameter as a function of the time between the appearances of the signal and of the additional signal, the calculation device being configured to compare the cardiac parameter with a threshold value whose exceeding is indicative of cardiac decompensation.
• the heart monitor provides an EKG trace that reflects the electrical signal generated by the user's heart activity.
• the heart monitor can be either also embedded in the implant or be disposed external to the implant, and more particularly external to the user.
• the heart monitor can be external and portable, of the Holter monitor type, and continuously record cardiac activity in relative autonomy.
• the heart monitor can be an external, non-portable scope requiring the intervention of medical personnel.
• the heart monitor can be internal, for example embedded in the implant, then operating independently once said implant is implanted.
• This additional signal value corresponds to the R wave identified on the electrocardiogram, i.e. the second positive wave of the electrocardiogram, appearing after the P wave, representative of a ventricular depolarization of the user. .
• the appearance of the additional signal constitutes a time marker in the determination of the cardiac parameter.
• pre-ejection period a period of time, otherwise known as the pre-ejection period or "PEP", which is the acronym for preejection period.
• PEP the cardiac parameter corresponding to the pre-ejection period is determined at least by means of the curve of accelerometric signals and the plot of
• the pre-ejection period is a time interval between the onset of the R wave and the onset of the maximum aortic valve opening.
• the cardiac parameter considered according to the invention and determined reproducibly and reliably due to the presence of the accelerometer in the implant is a time difference between the appearance of the additional signal determined on
• the electrocardiogram and the appearance of the determined signal on the accelerometric signal curve By studying the values obtained by the cardiac monitor, it is possible to determine the start of the pre-ejection period, and by studying the values obtained by the electrocardiogram, it is possible to determine the end of the pre-ejection period.
• the device for determining information relating to a state of cardiac decompensation of the user allows an approach multimodal for obtaining the cardiac parameter. It makes it possible to compare a curve of reliable and reproducible accelerometric signals to the trace of the electrocardiogram to obtain the cardiac parameter. A comparison between the cardiac parameter and the threshold value makes it possible to evaluate the cardiac activity of the user, and thus early detection of a state of cardiac decompensation. This comparison is carried out by the calculation device.
• the measuring device is configured to adopt a position in the implant such that the accelerometer is able to measure at least one acceleration along an axis among the dorso-ventral axis, a lateral axis and rostro-caudal axis of the user.
• the accelerometer is a one to three axis accelerometer including at least one of these 3 axes.
• the measuring device is configured to be implanted in the user intragastrically. Implantation close to the user's heart, such as intragastric implantation, provides an accelerometric signal curve specific to the user's heart activity. As discussed, the EKG is a
• the cells of the heart muscle under the impulse of a stimulation depolarize and transmit the electrical impulse step by step through the heart.
• the measurement of this electrical impulse can advantageously be made from the stomach, an organ located near the heart.
• two electrodes, a few centimeters apart from each other, are positioned in contact with the tissue of the gastric wall. They are connected to an integrated electronic module which conditions the signal measured by the electrodes. At an instant t, each of the electrodes will measure a different potential. The measurement of this potential difference between the two electrodes over time gives rise to an electrocardiogram.
• the measuring device is implanted intragrastrically by
• the measuring device is implanted so as to be attached to the gastric wall or inserted into the gastric wall.
• the measuring device is implanted in the upper part of the stomach, at or near the fundus of the stomach.
• the heart monitor can be configured to be housed in the implant.
• housed in the implant is meant that the monitor is embedded in the implant.
• the heart monitor can thus be for the most part housed within the implant itself and be connected to electrodes of the measuring member located on the surface of the implant or connected to the implant, the electrodes having to be in contact with the user's tissues.
• the implant thus accommodates both the heart monitor included in the measuring device and the measuring device including the accelerometer.
• the accelerometric signal curve and the electrocardiogram trace are obtained at the level of the implant, without external connection. This helps to obtain an accelerometric signal curve and a plot.
• the collected signals are then pre-processed directly by the onboard processor of the device or on the central server after transfer of the raw data.
• Pre-processing corresponds to filtering methods
• the heart monitor can be configured to be non-invasive.
• the heart monitor and the measuring device are physically separate from the measuring device.
• Such an arrangement makes it possible to provide a more compact implant, but it requires providing more complex synchronization means so that the signal measurements carried out invasively and those of the additional signal carried out non-invasive share the same time base.
• the heart monitor should be installed specifically when you want to measure the electrical activity of the heart.
• the electrocardiogram is obtained by placing measuring electrodes wired to the heart monitor on the user's chest.
• the measuring device is attached to the user, relative to the measuring device which, in the implant, is integrated with the user.
• the computing device is configured to be housed in the implant.
• the computing device is embedded with the measuring device. This configuration facilitates the implementation of the
• the computing device is for example configured to be disposed in the implant together with the accelerometer.
• the measuring device comprises a communication member configured to transfer at least one signal to the device. Calculation. It is understood that the communication member is associated both with the measuring device in the implant, that is to say at least with the accelerometer, and at the same time with the computing device.
• the communication unit comprises a transmitter for transferring the signal to a receiver included in the computing device. For example, one or more transmitters of the communication member are embedded in the implant, and one or more receivers are configured to receive, at the level of the computing device, the signal with a view to externalized processing of this signal.
• the signal, received from the measuring device comprises at least the accelerometric signals and / or a time marker corresponding to the appearance of the signal.
• the signal transmitted by the communication member to the calculation advantageously comprises both the accelerometric signals, the electrical signal generated by cardiac activity of the user, and / or a time marker corresponding to the appearance of the signal and / or a time marker corresponding to the appearance of the signal additional.
• the implant comprises an energy storage device capable of powering at least the measuring device.
• the energy storage device is advantageously internal to the implant and therefore miniaturized.
• it is a long-lasting energy storage device, such as a lithium-iodine type battery, which does not need to be connected to an external power source.
• the energy storage device is also able to power the measuring member.
• the invention also relates to a method for determining a
• the determination method implementing the determination device as previously described, during which a step of measuring signals makes it possible to obtain at least the signal value and the additional signal value, the signal value being obtained by the measuring device comprising at least the accelerometer and the additional signal value being obtained by the measuring device comprising at least the heart monitor.
• the step of measuring signals makes it possible to obtain the signal value.
• the accelerometer measures, during the signal measurement step, the accelerometric signals so as to obtain the signal curve
• the measurement device identifies on the curve of accelerometric signals the maximum opening of the aortic valve of the user corresponding to the signal value.
• the step of measuring signals makes it possible to obtain the additional signal value.
• the heart monitor measures, simultaneously with the signal measurement step and more particularly in a synchronous manner, that is to say by sharing the same time base, the electrical activity generated by a cardiac activity of the user so as to obtain
• the measuring device identifies on the EKG the R wave corresponding to the additional signal value.
• the step of measuring signals is followed by a step of calculating a cardiac parameter making it possible to obtain information on the state of cardiac decompensation, said step of calculating taking into account a time shift in the appearance of the signals measured in the signal measurement step.
• the time offset considered during this calculation step is read instantly due to the synchronous measurement of the signal and the additional signal, that is to say with a time base identical to the two signals.
• the accelerometric signal curve and the electrocardiogram are compared on the same time frame of reference so as to be able to obtain the cardiac parameter corresponding to the time lag between the appearance of the value of the signal and the appearance of the value of the signal.
• the R wave indicates the start of the pre-ejection period and the user's maximum aortic valve opening indicates the end of the pre-ejection period.
• the determination method comprises a step of calibrating the measuring device, the calibration step preceding the step of measuring signals.
• the calibration step makes it possible to obtain the threshold value, which is a reference value, the exceeding of which is indicative of cardiac decompensation.
• the cardiac parameter is specific to each user, by its cardiac activity which is specific to the user, and by the position of the measuring device, and particularly the position of
• the calibration step allows the determination process to be personalized. In particular, it makes it possible to obtain a reference signal value specific to the user. It will be understood that the reference signal value is intended to be an average of values sufficiently representative of the user's basal situation.
• the step of calculating a cardiac parameter making it possible to obtain information on the state of cardiac decompensation is carried out not by an instantaneous approach. , consisting of a calculation of a cardiac parameter for a signal value and a corresponding additional signal value, but by an averaged approach. More particularly, the measurement of the cardiac parameter
• corresponding to the pre-ejection period is carried out on a coherent average representing the average of the signal acquired over 30 seconds, and therefore also on an additional coherent average representing the average of the additional signal acquired synchronously over the same period.
• the result of the calculation of a cardiac parameter at a given time is recorded in an overall clinical picture.
• a daily clinical picture can thus be generated for comparison with previous clinical pictures or a reference clinical picture obtained during the calibration step. More specifically, the value of the parameter on day D will be compared to that on day D-1 and the plot of the values over the days will show a trend, either downward or upward which could mean a problem, or a stable line indicating no major hemodynamic change.
• the calculation device can compare, during the calculation step, the cardiac parameter with a threshold value, which can in particular be adjusted to the user during the step of. calibration.
• the computing device manages the integration of parameters, including cardiac parameter and threshold value, to obtain information on the state of cardiac decompensation.
• the threshold value is derived from the reference signal value.
• the threshold value represents a percentage, variable as a function of a calibration step prior to the implementation of the device, of the reference signal value.
• the cardiac parameter is both calculated and is also compared to the threshold value determined during the calibration step. The cardiac parameter / threshold value comparison makes it possible to precisely determine the user's cardiac decompensation state.
• FIG. 1 is a general schematic view of a determination device according to the invention.
• FIG. 2 is a general schematic view of a determination device according to the invention in another embodiment
• FIG. 3 is an illustration of a method of determining information relating to a state of cardiac decompensation of a user, the determination method implementing the determination device according to the invention
• FIG. 4 is a flowchart illustrating the determination method of FIG. 3.
• the names "internal” and “external” refer to the determination device according to the invention and more particularly to an implant forming part of this determination device. Any element integrated into an implant of the device is called internal or internalized.
• FIG. 1 there is seen a device 1 for determining information relating to a state of cardiac decompensation of a user 2.
• the information relating to a state of cardiac decompensation is obtained by analysis of a cardiac parameter illustrated in FIG. 3.
• the determination device 1 comprises at least one measuring device 3, a measuring device 4 and a computing device 5. In this case, part of the determining device 1, with the measuring device 3, is internalized and another part of the determination device 1, with the measuring device 4 and the computing device 5, is externalized.
• the measuring device 3 comprises at least one accelerometer 30 configured to determine an accelerometric signal curve of the user 2, illustrated in FIG. 3. The measuring device 3 is configured to determine a signal value, also illustrated in figure 3.
• the measuring device 3 including the accelerometer 30 is housed in an implant 6 internal to the user 2.
• the implant 6 corresponds to a hollow, biocompatible and sealed compartment.
• the implant 6 is sized to be implanted using an endoscopic device.
• the representation of the implant 6 in Figure 1 is schematic, and the implant 6 can take any shape and size compatible with its implantation, its function and the operation of the device.
• the implant 6 is an intragastric implant, positioned, in the example of FIG. 1, at the level of the fundus 20 of the stomach 21 of the user 2, near the heart 26 of the user 2.
• the implant 6 is for example fixed on the surface of a gastric mucosa or within the gastric mucosa, at the level of the fundus 20 of the stomach 21, or at the level of any tissue of the gastrointestinal tract 25.
• the implant 6 comprises an energy storage device 60 capable of supplying at least the measuring device 3.
• the energy storage device 60 is miniaturized and isolated from the tissues of the user 2, as here in being internal to the implant 6.
• the energy storage device 60 is configured to have a lifespan of several years so as to be able to supply the measuring device 3 as required.
• the measuring device 3 is configured to adopt a position in
• the implant 6 such that the accelerometer 30 is able to measure at least one acceleration along an axis among the dorso-ventral axis 22, a lateral axis 23 and a rostro-caudal axis 24 as illustrated in Figure 1.
• Measuring device 4 is configured to measure a signal value
• the heart monitor 40 comprises at least one heart monitor 40.
• the heart monitor 40 externalized in this embodiment illustrated in Figure 1, is provided with a display screen 41 for viewing a trace an EKG, as shown in Figure 3.
• the heart monitor 40 is connected by wire sensors 42 of the measuring member 4 to a set here of three electrodes 43 each individually connected to the heart monitor 40 and affixed to the user 2.
• This representation of the organ measurement 4 is not restrictive, in particular with regard to the number of electrodes 43 used, the measurement member 4 being able to take any form provided that it makes it possible to measure the value of the additional signal.
• the computing device 5 is configured to determine a value of the
• the calculating device 5 can also be configured to compare the cardiac parameter with a threshold value whose exceeding is indicative of cardiac decompensation.
• the computing device 5 is external. It is on the one hand electrically connected, by a wiring 50, to the heart monitor 40 so as to receive the additional signal value. It is also connected wirelessly to the measuring device 3.
• the measuring device 3 comprises for this purpose a communication member 31 configured to transfer at least one signal to the computing device 5, in this case the value signal.
• the measuring device 3 comprises in particular a transmitter 32 of waves 33, the transmitter 32 being internal to the implant 6 and being connected to the measuring device 3.
• the calculating device 5 comprises a receiver 51 capable of receiving the waves 33. transmitted by the transmitter 32 of the communication unit 31.
• FIG. 2 shows another exemplary embodiment of the invention, internalizing the measuring member 4.
• the implant incorporates both
• the determination device 1 is partly compacted, the measuring device 3 and the measuring member 4 being embedded in the implant 6, only the calculation device 5 being here outsourced.
• FIG. 1 applies mutatis mutandis to FIG. 2 and reference may be made to it in order to understand and implement the invention.
• the heart monitor 40 is configured to be housed in the implant 6. It is, like the measuring device 3, powered by the energy storage device 60.
• the communication device 31 is shared between measuring device 3 and measuring device 4, so that it transfers both the signals from the accelerometer 30 and the signals from the heart monitor 40.
• the measuring device 3 and the measuring device 4 each comprise a transmitter 32 of the communication device 31 which transmits by waves 33 the signal value and the additional signal value to one or more receivers of the computing device 5 .
• the calculation device or at least in part, is also integrated into the implant 6.
• part of the calculation takes place in the implant, to namely the measurement and detection of the appearance of the two time signals, and that it is only the values of these time signals that are transmitted to an external database.
• Figure 3 illustrates various cardiac data, measured and determined by the determination device 1.
• the signal value 34 corresponds to a time value determined by means of at least the curve of accelerometric signals 35 of user 2 obtained by the accelerometer 30.
• the accelerometric signal curve 35 comprises positive peaks and negative peaks, including a maximum opening of the aortic valve of user 2. When said opening maximum of the aortic valve is identified, it is defined as corresponding to the signal value 34 on the signal curve
• the computing device 5 deduces therefrom a time marker 36, for example at a time t1 on a given time base.
• the electrocardiogram 45 comprises positive waves and negative waves, among which one can count a P wave 450, a Q wave 451, R wave 452, S wave 453, T wave 454, U wave 455.
• the maxima of R wave 452 is identified, it is defined as corresponding to the value of additional signal 44 on the electrocardiogram 45.
• the computing device 5 deduces therefrom a time marker 46, for example at a time t0 on the basis of time common to that used to determine the first time marker 36.
• the appearance of the signal 34 is intended to be compared chronologically with the appearance of the additional signal 44.
• the calculating device as described above is configured to calculate a time duration between the value of the time marker 36 and the value of the time marker 46.
• the value of the pre-ejection period that is to say of the cardiac parameter 27, corresponds to this time duration between the time marker 36 and the time marker 46.
• FIG. 4 illustrates a flowchart representative of a method 7 for determining information relating to a state of cardiac decompensation of a user 2, the method for determining 7 using the determination device 1 as previously. described in FIG. 1.
• the determination method 7 comprises at least one signal measurement step 70 and a calculation step 71.
• the determination method 7 comprises at least one calibration step 72.
• Each step is represented by a rectangle in FIG. 4, the succession of steps being according to a chronology indicated by arrows 100.
• the calibration step 72 makes it possible to calibrate at least the measuring device 3. It is understood that the calibration step is theoretically carried out only once before the device is operational for taking measurements
• the objective of the calibration step being to set a basal state, this state being kept for each of the measurement steps which follow.
• several calibration steps 72 of the measuring device 3 can be envisaged, for example when using the measuring device 3 post-implantation, or at a distance from the setting. in place of the implant 6.
• the calibration step 72 makes it possible to determine a threshold value 73 which is representative both of the basal cardiac activity of the user 2 and of the positioning of the accelerometer 30. More particularly, step d calibration 72 consists of multiplying measurements of the cardiac parameter and calculating an average value of these measurements to derive therefrom a reference signal value 37. From the reference signal value 37, a threshold value 73, corresponding to a percentage of the value of the reference signal 37, is determined, and this threshold value 73 is intended to be compared with the cardiac parameters 27 obtained during measurement steps following step
• the signal measurement step 70 At least the signal value 34 and the additional signal value 44 are obtained.
• the measuring device 3 and more particularly the accelerometer 30, is implemented to obtain the signal value 34.
• the measuring member 4 and more
• the cardiac monitor 40 is implemented to obtain the additional signal value 44.
• the first measurement sub-step 700 and the second measurement sub-step 701 take place concomitantly so as to that the values obtained can be compared on the same time frame so that the parameter can be calculated cardiac 27 during the calculation step 71. It will be understood that without departing from the context of the invention, these two sub-steps can be carried out in a staggered manner, in particular if the measurement of one of the signals should interfere with the measurement of the other signal.
• the signal measurement step 70 is followed by the calculation step 71 of the
• the calculation step 71 being implemented by the calculation device 5.
• the calculation step 71 can be carried out periodically or regularly, or following each measurement step 70 of the signals, and / or at the request of user 2 or medical personnel.
• Calculation step 71 identifies the time marker 36 and the
• time marker 46 and deduce the cardiac parameter 27 therefrom.
• the time marker 36 is identified.
• the time marker 46 is identified.
• the calculation device 5 compares the cardiac parameter 27 with the threshold value 73 determined during the calibration step 72 or with a value threshold implemented theoretically in the computing device.
• information 74 is obtained on the state of cardiac decompensation of user 2 during an information step 75. If the cardiac parameter 27 detected corresponds at a value beyond the threshold value, user 2 is for example in an early state of
• This determination device configured to prevent an early state of cardiac decompensation. This determination device, intended
• the user in particular to be at least partially implanted in the user, comprises at least one accelerometer participating in determining a pre-ejection period by allowing the reliable detection of a signal value to be compared with an additional signal, the integration of this accelerometer in an implant allowing this reliable measurement.
• the information obtained by such a determination device is intended to be reliable and allows frequent use so as to ensure simple and recurrent monitoring of a user at risk of cardiac complications.
• the shape of the determination device can be changed without harming the invention, to the extent that the determination device, ultimately, fulfills the same functionalities as those described in this document.

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• 2019
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