Abstract: A method of determining one or more physiological parameter of a patient by providing a plurality of implantable electrodes proximate a blood vessel of the patient, applying a measurement signal through the plurality of electrodes, the measurement signal having a known parameter, obtaining a resultant signal through the plurality of electrodes, the resultant signal having a resultant parameter, calculating vascular impedance based on the measurement signal and the resultant signal, and calculating a physiological parameter based on the vascular impedance. In some embodiments, the physiological parameter is utilized to modify a therapy signal controlling therapy delivered to the patient.

Abstract: Methods for treating a renal associated condition in a subject are provided. Aspects of the subject methods include paradoxically enhancing renal sympathetic bias in the subject in a manner effective to treat the renal associated condition. Also provided are compositions, kits and systems for practicing the subject methods.

Abstract: A neurostimulation device includes an external neurostimulator worn by a patient using a bracing element that braces a portion of the patient's body. The external neurostimulator delivers neurostimulation to modulate a cardiovascular function of the patient. In one embodiment, the external stimulator delivers the neurostimulation transcutaneously to a stimulation target in the patient's body using surface stimulation electrodes placed on the body approximately over the stimulation target.

Abstract: Provided herein are methods, devices, compositions, and kits for monitoring neuromodulation efficacy based on changes in the level or activity of one or more target biomarkers.

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract: Apparatus and methods are described including a mechanical support element that is placed inside a first vein of a subject. At least one electrode disposed on the mechanical support element is placed inside the first vein, in a vicinity of a site upstream of a bifurcation with a second vein of the subject. A control unit enhances downstream blood flow from the first vein by driving the at least one electrode to divert blood downstream into the second vein by constricting the first vein at the upstream site, by driving the at least one electrode to apply a current to the vicinity of the site. The mechanical support element prevents the first vein from collapsing by providing mechanical support to the vein. Other embodiments are also described.

Abstract: A therapy system for applying an electrical signal to an internal anatomical feature of a patient includes an implantable component and an external component. The medical device can be checked for safety issues by periodically initiating a sequence of tests of an H-bridge circuit, and, during each test, monitoring a current flow through a sensing resistor electrically connected between a sensing connection of the H-bridge circuit and a ground. Current flow through the sensing resistor indicates that both series electrical switches within at least one of the two pairs of series electrical switches are active during that test.

Abstract: A method and apparatus for treating a condition associated with impaired blood pressure and/or heart rate in a subject comprising applying an electrical treatment signal, wherein the electrical treatment signal is selected to at least partially block nerve impulses, or in some embodiments, to augment nerve impulses. In embodiments, the apparatus provides a first therapy program to provide a downregulating signal to one or more nerves including renal artery, renal nerve, vagus nerve, celiac plexus, a splanchnic nerve, cardiac sympathetic nerves, spinal nerves originating between T10 to L5. In embodiments, the apparatus provides a third therapy program to provide an upregulating signal to one or more nerves including a glossopharyngeal nerve and/or a tissue containing baroreceptors.

Abstract: Electrical crosstalk between two implantable medical devices or two different therapy modules of a common implantable medical device may be evaluated, and, in some examples, mitigated. In some examples, one of the implantable medical devices or therapy modules delivers electrical stimulation to a nonmyocardial tissue site or a nonvascular cardiac tissue site, and the other implantable medical device or therapy module delivers cardiac rhythm management therapy to a heart of the patient.

Abstract: The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a burst mode stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder. The burst stimulus comprises a plurality of groups of spike pulses having a maximum inter-spike interval of 100 milliseconds. The burst stimulus is separated by a substantially quiescent period of time between the plurality of groups of spike pulses. This inter-group interval may comprise a minimum of 5 seconds.

Abstract: A method of determining one or more physiological parameter of a patient by providing a plurality of implantable electrodes proximate a blood vessel of the patient, applying a measurement signal through the plurality of electrodes, the measurement signal having a known parameter, obtaining a resultant signal through the plurality of electrodes, the resultant signal having a resultant parameter, calculating vascular impedance based on the measurement signal and the resultant signal, and calculating a physiological parameter based on the vascular impedance. In some embodiments, the physiological parameter is utilized to modify a therapy signal controlling therapy delivered to the patient.

Abstract: A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.

Abstract: Various aspects of the present subject matter provide a device. In various embodiments, the device comprises a port adapted to connect a lead, a pulse generator connected to the port and adapted to provide a neural stimulation signal to the lead, and a signal processing module connected to the port and adapted to receive and process a nerve traffic signal from the lead into a signal indicative of the nerve traffic. The device includes a controller connected to the pulse generator and the signal processing module. The controller is adapted to implement a stimulation protocol to provide the neural stimulation signal with desired neural stimulation parameters based on the signal indicative of the nerve traffic. Other aspects are provided herein.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Systems, methods and devices for paired training include timing controls so that training and neural stimulation can be provided simultaneously. Paired trainings may include therapies, rehabilitation and performance enhancement training. Stimulations of nerves such as the vagus nerve that affect subcortical regions such as the nucleus basalis, locus coeruleus or amygdala induce plasticity in the brain, enhancing the effects of a variety of therapies, such as those used to treat tinnitus, stroke, traumatic brain injury and post-traumatic stress disorder.

Abstract: Medical devices and methods for making and using the same are disclosed. An example method may include a method for treating a patient having congestive heart failure. The method may include positioning an expandable balloon in a renal artery of the patient. The expandable balloon may include a plurality of electrode assemblies. At least some of the electrode assemblies each may include at least two bipolar electrode pairs. The two bipolar electrode pairs may be longitudinally and circumferentially offset from one another. The method may also include expanding the balloon in the renal artery such that at least some of the bipolar electrode pairs are electrically coupled to a wall of the renal artery and energizing at least some of the bipolar electrode pairs so as to therapeutically alter at least one nerve proximate the renal artery to treat the patient's congestive heart failure.

Abstract: Methods for treating polycystic kidney disease with therapeutic renal neuromodulation and associated systems and methods are disclosed herein. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a renal artery of a kidney of a patient. One or more measurable physiological parameter corresponding to the polycystic kidney disease can thereby be reduced. Moreover, central sympathetic drive in the patient can be reduced in a manner that treats the patient for the polycystic kidney disease. Renal sympathetic nerve activity can be modulated along the afferent and/or efferent pathway. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a neuromodulation assembly, e.g., a neuromodulation assembly configured to cryotherapeutically cool the renal nerve or to deliver an energy field to the renal nerve.

Abstract: Some embodiments provide a system, comprising a peripheral nerve field modulation (PNFM) therapy delivery system, PNFM electrodes configured to be implanted subcutaneously, and a controller. The PNFM electrodes are electrically connected to the PNFM therapy system. The PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields. The controller is configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields. The controller includes a scheduler configured to control timing of the PNFM therapy.

Abstract: An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.

Abstract: Disclosed herein, among other things, is a system for electrical stimulation of blood vessels. An embodiment of the system includes at least one electrode having electrical contact with a blood vessel. The embodiment also includes a stimulation circuit electrically connected to the electrode, the circuit adapted to provide stimulation to the vessel. The embodiment further includes a controller connected to the circuit, the controller adapted to select frequency and voltage parameters for the stimulation circuit to selectively affect vascular therapy, including constriction of the vessel and dilation of the vessel. According to various embodiments, the stimulation circuit and controller are contained within an implantable medical device (IMD). The system also includes a sensor connected to the controller, and the controller initiates and adjusts therapy based on a signal received from the sensor, in varying embodiments.

Abstract: A transvascular electrode system includes an expandable electrode-carrying anchor. The anchor is intravascularly advanced in a compressed position to a first site in a blood vessel. A first portion of the anchor expands to position an electrode against the vessel wall, while a second portion remains is compressed. Mapping is performed by delivering stimulation energy from the electrode and measuring the response (e.g. blood pressure, heart rate, and/or related parameters). The first portion is at least partially collapsed and the electrode system is moved to a second site. The first portion is expanded to position the electrode into against the vessel wall, while the second portion remains compressed. Additional mapping is performed. The process is repeated until the anchor electrode position is optimized, at which point the second portion of the anchor is expanded to chronically retain the electrode in the vessel.

Abstract: A method that electrically stimulates a heart muscle to alter the ejection profile of the heart, to control the mechanical function of the heart and reduce the observed blood pressure of the patient. The therapy may be invoked by an implantable blood pressure sensor associated with a pacemaker like device. In some cases, where a measured pretreatment blood pressure exceeds a treatment threshold, a patient's heart may be stimulated with an electrical stimulus timed relative to the patient's cardiac ejection cycle. This is done to cause dyssynchrony between at least two cardiac chambers or within a cardiac chamber, which alters the patient's cardiac ejection profile from a pretreatment cardiac ejection profile. This has the effect of reducing the patient's blood pressure from the measured pretreatment blood pressure.

Abstract: Devices and methods for use of identification, treatment and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes, determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, generating at least one signal representative of a pressure waveform based on the impedance, activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

Abstract: A device according to some embodiments may include an implantable flexible carrier and a pair of electrodes located on the carrier. The electrodes may be spaced from each other by a distance greater than 3 mm, and may be configured to cause, when supplied with an electrical signal, a unidirectional electric field sufficient to modulate at least one nerve.

Abstract: A device may include at least one pair of modulation electrodes configured for implantation in the vicinity of a nerve to be modulated such that the electrodes are spaced apart from one another along a longitudinal direction of the nerve to be modulated. The electrodes may be further configured to facilitate an electric field in response to an applied electric signal, the electric field including field lines extending in the longitudinal direction of the nerve to be modulated. The device may further include at least one circuit in electrical communication with the at least one pair of modulation electrodes and being configured to cause application of the electric signal applied at the at least one pair of modulation electrodes.

Abstract: A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device.

Abstract: A device for delivering energy as a function of degree coupling may include an external unit configured for location external to a body of a subject and at least one processor associated with the implant unit and configured for electrical communication with a power source. The device may further include a primary antenna associated with the at least one processor. The processor may be configured to determine a degree of coupling between the primary antenna and a secondary antenna associated with the implant unit, and regulate delivery of power to the implant unit based on the degree of coupling between the primary antenna and the secondary antenna.

Abstract: A device according to some embodiments of the present disclosure includes a housing configured to retain a battery, a primary antenna associated with the housing, and at least one processor in electrical communication with the battery and the primary antenna. In some embodiments, the at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device during a treatment session of at least three hours in duration, wherein the primary signal is generated using power supplied by the battery and includes a pulse train, the pulse train including a plurality of modulation pulses.

Abstract: A device for regulating energy delivery to an implanted circuit is disclosed. The device may include at least one implantable circuit and at least one pair of implantable electrodes in electrical communication with the circuit. The at least one pair of implantable electrodes may be configured to modulate at least one nerve. The at least one implantable circuit may be configured deliver a signal to the at least one pair of implantable electrodes. The signal may have at least one of a power level or a duration determined based on a severity of a detected physiologic condition.

Abstract: A device according to some embodiments may include a housing configured for location external to a body of a subject. The device may also include at least one processor associated with the housing and configured for electrical communication with a power source, and an antenna associated with the at least one processor. The at least one processor may be configured to communicate with an implant circuit located within the body of the subject, cause the implant circuit to receive power in a first power mode and in a second power mode, wherein a first level of power delivered in the first power mode is less than a second level of power delivered in the second power mode, and wherein during a therapy period, power delivery in the first mode occurs over a total time that is greater than about 50% of the therapy period.

Abstract: A device according to some embodiments may include a housing configured for location external to a body of a subject. The device may also include at least one processor associated with the housing and configured to communicate with a circuit implanted in the subject within proximity to a tongue of the subject, wherein the circuit is in electrical communication with at least one electrode, receive a physiological signal from the subject via the circuit, and send a control signal to the implanted circuit in response to the physiological signal, wherein the control signal is predetermined to activate neuromuscular tissue within the tongue.

Abstract: An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein.

Abstract: One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

Abstract: Devices and methods of use are described for detecting and treating an undesirable level of fluid in a pulmonary circulation of a patient. An exemplary system may include an implantable baroreflex activation device including an electrode configured to be implanted proximate a baroreptor within a patient, an implantable sensor configured to provide an indication of a fluid level within the patient, and a control system coupled to the baroreflex activation device and the sensor. The control system may be programmed to automatically detect a level of a fluid in a pulmonary circulation of the patient with the sensor and upon detecting an undesirable level of the fluid in the pulmonary circulation, delivering a therapy via the electrode of the baroreflex activation device to reduce the level of fluid in the pulmonary circulation.

Abstract: An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter.

Abstract: Various aspects of the present subject matter provide a device. In various embodiments, the device comprises a port adapted to connect a lead, a pulse generator connected to the port and adapted to provide a neural stimulation signal to the lead, and a signal processing module connected to the port and adapted to receive and process a nerve traffic signal from the lead into a signal indicative of the nerve traffic. The device includes a controller connected to the pulse generator and the signal processing module. The controller is adapted to implement a stimulation protocol to provide the neural stimulation signal with desired neural stimulation parameters based on the signal indicative of the nerve traffic. Other aspects are provided herein.

Abstract: A neurostimulation device includes an external neurostimulator worn by a patient using a bracing element that braces a portion of the patient's body. The external neurostimulator delivers neurostimulation to modulate a cardiovascular function of the patient. In one embodiment, the external stimulator delivers the neurostimulation transcutaneously to a stimulation target in the patient's body using surface stimulation electrodes placed on the body approximately over the stimulation target.

Abstract: An implantable neural stimulation system includes an implantable medical device having a neural stimulation circuit and at least one implantable lead configured to allow one or more stimulation electrodes to be placed in one or more lymphatic vessels of a patient, such as the patient's thoracic duct and/or vessels branching from the thoracic duct. Neural stimulation pulses are delivered from the implantable medical device to one or more target regions adjacent to the thoracic duct or the vessels branching from the thoracic duct through the one or more stimulation electrodes.

Abstract: Methods and systems are disclosed for stimulating contents of the carotid sheath using an intravascular pulse generator and lead. The lead carries an energy delivery device such as an electrode, which is anchor within the portion of the internal jugular vein that is disposed within the carotid sheath. The energy delivery device is energized to transvenously direct energy to target contents of the carotid sheath external to the internal jugular vein. Such target contents may include nervous system elements associated with the carotid sinus baroreceptors, the carotid sinus nerve and associated nerve branches, and or the vagus nerve and associated nerve branches. The system may be used to control blood pressure and/or to lower heart rate and may be suitable for treatment of hypertension, heart failure, or other conditions.

Abstract: Devices and methods of use for identification, treatment, and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system including a blood pressure sensor and a heart rate sensor, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including an electrode, providing a control system coupled to the baroreflex therapy system and the implantable measurement device, the control system programmed to automatically determine an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, determine arterial stiffness of the blood vessel based on the impedance, determine blood pressure and heart rate, and activate, deactivate or otherwise modulate the baroreflex therapy system to deliver a baroreflex therapy based on the blood pressure, heart rate and arterial stiffness.

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract: A method and apparatus for treatment of hypertension and heart failure by increasing secretion of endogenous atrial hormones by pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in premature atrial contraction that does not result in ventricular contraction. Pacing results in the atrial wall stress, peripheral vasodilation, ANP secretion. Concomitant reduction of the heart rate is monitored and controlled as needed with backup pacing.

Abstract: Devices and methods of use identification, treatment, and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes, determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, generating at least one signal representative of a pressure waveform based on the impedance, activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Devices and methods of use identification, treatment, and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system including a blood pressure sensor and a heart rate sensor, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including an electrode, providing a control system coupled to the baroreflex therapy system and the implantable measurement device, the control system programmed to automatically determine an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, determine arterial stiffness of the blood vessel based on the impedance, determine blood pressure and heart rate, and activate, deactivate or otherwise modulate the baroreflex therapy system to deliver a baroreflex therapy based on the blood pressure, heart rate and arterial stiffness.

Abstract: An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein.

Abstract: One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein.

Abstract: Baroreflex activation is achieved by providing suitable control signals to a baroreflex activation device. A method comprises establishing a therapy interval within the therapy interval, establishing a plurality of dose intervals, and generating an electrical output signal. The electrical output signal has a time dependence such that the average electrical power applied to the baroreflex activation device differs between first and second portions of at least some dose intervals. Another method comprises establishing a series of therapy interval portions, during at least some therapy intervals, establishing a plurality of burst intervals, and generating an electrical output signal. The electrical output signal has a time dependence such that the average electrical power applied to the baroreflex activation device differs between first and second portions of the therapy intervals and also differs between first and second portions of at least some burst intervals.

Abstract: The present invention relates to neurological systems and methods of use which acquire physiological signals from a subject and stimulate the subject. The system is adapted to control the timing at which the system acquires the physiological signals from the subject and the timing of the stimulation signal to reduce the amount of stimulation induced artifact that is acquired by the system.