Abstract: The disclosure is directed to a user interface with a menu that facilitates stimulation therapy programming. The user interface displays a representation of the electrical leads implanted in the patient and at least one menu with icons that the user can use to adjust the stimulation therapy. The user may drag one or more field shapes from a field shape selection menu onto the desired location relative to the electrical leads. A manipulation tool menu may also allow the user to adjust the field shapes placed on the electrical leads, which represent the stimulation region. The programmer that includes the user interface then generates electrical stimulation parameter values for the stimulator to deliver stimulation according to the field shapes or field shape groups defined/located by the user. The field shapes may represent different types of stimulation representations, such as current density, activation functions, and neuron models.

Abstract: A method and apparatus for delivering corrective therapy through hormone regulation is provided. Inhibition of sympathetic fibers by spinal cord stimulation is used to regulate the levels of hormones such as catecholamines, renin, and calcitonin gene-related peptide. The invention utilizes a closed or open loop feedback system in which physiological parameters such as the concentrations of hormones and sympathetic indicators such as heart rate and urine production are monitored and used to determine the appropriate level of neurostimulation.

Abstract: An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.

Abstract: The invention is directed to a technique for rating neuromodulation efficacy based on evaluation of the response of the patient to sensory stimuli with and without delivery of neuromodulation therapy. In addition, the invention may provide a system capable of delivering sensory stimuli on a quantitative basis in a coordinated manner with delivery of neuromodulation therapy. A device programmer may provide a platform for controlling delivery of the sensory stimuli, delivery of neuromodulation therapy, and generation of rating information for neuromodulation efficacy based on patient sensory response to the stimuli. In operation, the programmer controls application of selected sensory stimuli to the patient's body and records the patient's verbal or physiological responses to the stimuli. This invention can be used to be a diagnostic or prognostic test that a given neuromodulation therapy, such as neurostimulation or drug delivery, is and will be successful.

Abstract: Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least five combination groups. A first group of electrode combinations is characterized by the presence of a caudal anode. A second group of electrode combinations is characterized by the presence of a rostral anode. A third group of electrode combinations is characterized by the presence of a single anode above and a single anode below the cathode(s) of the combination. A fourth group of electrode combinations is characterized by the presence of multiple anodes above and below the cathode(s) of the combination. A fifth group of electrode combinations is characterized by the presence of transverse anodes. A sixth group of electrode combination is characterized by at least one off-center cathode. One or more preferred electrode combinations groups, and/or a number of leads to implant within the patient, may by selected based on patient feedback.

Abstract: Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least two electrode combination classes during a therapy evaluation period. A first one of the classes comprises one or more electrode combinations that include electrodes within one or two columns of an implantable array of electrodes. The array may include at least three electrode columns. A second one of the classes comprises one or more electrode combinations that include electrodes within at least three electrode columns of the implantable array of electrodes. A preferred one of the electrode combination classes for a patient, and/or a number of leads to implant within the patient, may by selected based on feedback collected from the patient during the therapy evaluation period.

Abstract: An implantable medical device includes a controlling device for transmitting a first series of command signals, the controlling device comprising a connector block, a first lead body including at least one electrical lead, and a hermetic encasement. The hermetic encasement includes a housing defining an interior space, an electronic network housed within the interior space and configured to receive the first set of command signals from the controlling device and output a second series of command signals based on the first set of command signals, a first set of one or more feedthrough terminals extending through the housing and directly coupling the electronic network to the connector block, and a second set of one or more feedthrough terminals extending through the housing and directly coupling the electronic network to the first lead body.

Abstract: A method and apparatus for delivering corrective therapy through hormone regulation is provided. Inhibition of sympathetic fibers by spinal cord stimulation is used to regulate the levels of hormones such as catecholamines, renin, and calcitonin gene-related peptide. The invention utilizes a closed or open loop feedback system in which physiological parameters such as the concentrations of hormones and sympathetic indicators such as heart rate and urine production are monitored and used to determine the appropriate level of neurostimulation.

Abstract: A method and apparatus to provide therapy to a patient for protecting cardiac tissue from insult is disclosed. The method comprises delivering closed loop electrical stimulation to one or more predetermined portions of a portion of excitable tissue of the spinal cord of a patient; and monitoring one or more physiologic indices of the body. That is, a closed-loop feedback controller is used to apply electrical stimulation to preselected regions of the spinal cord of a patient's body based upon one or more aspects of the physiologic indices.

Abstract: The invention is directed to a technique for rating neuromodulation efficacy based on evaluation of the response of the patient to sensory stimuli with and without delivery of neuromodulation therapy. In addition, the invention may provide a system capable of delivering sensory stimuli on a quantitative basis in a coordinated manner with delivery of neuromodulation therapy. A device programmer may provide a platform for controlling delivery of the sensory stimuli, delivery of neuromodulation therapy, and generation of rating information for neuromodulation efficacy based on patient sensory response to the stimuli. In operation, the programmer controls application of selected sensory stimuli to the patient's body and records the patient's verbal or physiological responses to the stimuli. This invention can be used to be a diagnostic or prognostic test that a given neuromodulation therapy, such as neurostimulation or drug delivery, is and will be successful.

Abstract: Apparatus and techniques to address the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as_electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Abstract: Neurostimulation is delivered to one or more predetermined locations on or within a patient in order to treat effects of sleep apnea by modulating autonomic nervous activity. Delivery of neurostimulation at predetermined locations can decrease sympathetic nervous activity and/or increase parasympathetic nervous activity, countering the increased intrinsic sympathetic activity associated with apnea-arousal cycles. In some embodiments, neurostimulation is delivered to the spinal cord of the patient via an implanted electrode. In other embodiments, neurostimulation is delivered transcutaneously to the spinal cord or other locations via electrodes located on the surface of the patient. In some embodiments, delivery of neurostimulation is initiated or modified in response to detection of apneas.

Abstract: An implantable medical device for stimulating electrically excitable tissue within a patient, and more particularly relates to such a system having a pulse generator and a lead. The lead includes a first set of electrodes including at least three electrodes. The lead also includes a second set of electrodes including at least first, second and third electrodes. The first and second electrodes are positioned on opposite sides of an imaginary longitudinal axis that passes through the center of the third electrode. The second set of electrodes is located at or nearer to the proximal portion of the lead relative to the location of the first set of electrodes.

Abstract: An implantable medical device (IMD) for gauging the severity of ischemia in a patient's heart includes a data collection module configured to receive data about the patient's heart, a data processing module configured to process the data to identify an episode of ischemia in the patient and to determine if the episode is stable or unstable, and a reporting module configured to provide an alarm to the patient if the episode is unstable. A method executable by an implantable medical device to detect ischemia in a human heart suitably includes the steps of receiving data about the heart at the implantable medical device, processing the data within the implantable medical device to determine the severity of ischemia, and providing a response from the implantable medical device to the patient if ischemia is indicated.

Abstract: A method and apparatus are provided for protecting cardiac tissue from insult. The method comprises identifying the occurrence of an insult, such as a heart attack, and delivering electrical stimulation to one or more predetermined nerves in a patient's body in response to identifying the occurrence of the insult. The stimulation may be provided at the spinal canal or on the chest wall of the patient through cutaneous electrodes.

Abstract: The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

Abstract: A desired effect is produced by therapeutically activating tissue at a first site within a patient's body and a corresponding undesired side effect is reduced by blocking activation of tissue or conduction of action potentials at a second site within the patient's body by applying high frequency stimulation and/or direct current pulses at or near the second site. Time-varying DC pulses may be used before or after a high frequency blocking signal. The high frequency stimulation may begin before and continue during the therapeutic activation. The high frequency stimulation may begin with a relatively low amplitude, and the amplitude may be gradually increased. The desired effect may be promotion of micturition or defecation and the undesired side effect may be sphincter contraction. The desired effect may be defibrillation of the patient's atria or defibrillation of the patient's ventricles, and the undesired side effect may be pain.

Abstract: Apparatus and techniques to address the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as_electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

Abstract: A method and apparatus for delivering corrective therapy through hormone regulation is provided. Inhibition of sympathetic fibers by spinal cord stimulation is used to regulate the levels of hormones such as catecholamines, renin, and calcitonin gene-related peptide. The invention utilizes a closed or open loop feedback system in which physiological parameters such as the concentrations of hormones and sympathetic indicators such as heart rate and urine production are monitored and used to determine the appropriate level of neurostimulation.

Abstract: Neurostimulation is delivered to one or more predetermined locations on or within a patient in order to treat effects of sleep apnea by modulating autonomic nervous activity. Delivery of neurostimulation at predetermined locations can decrease sympathetic nervous activity and/or increase parasympathetic nervous activity, countering the increased intrinsic sympathetic activity associated with apnea-arousal cycles. In some embodiments, neurostimulation is delivered to the spinal cord of the patient via an implanted electrode. In other embodiments, neurostimulation is delivered transcutaneously to the spinal cord or other locations via electrodes located on the surface of the patient. In some embodiments, delivery of neurostimulation is initiated or modified in response to detection of apneas.