Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: One aspect of the present disclosure relates to a system that can provide an electric waveform for neural stimulation or nerve block. The system can include a first circuit component configured to provide a self-oscillating, voltage-boosted electric waveform. In some instances, the first circuit component can provide a “pause” waveform (e.g., with a period (T) that includes a swing time (ts) in which the waveform varies in a biphasic manner and a pause time (tp) in which the waveform has a constant amplitude). The system can also include a second circuit component configured to ensure that the oscillating signal is charge-balanced across at least one period of the self-oscillating, voltage-boosted electric waveform.

Abstract: Described herein are systems and methods for applying extremely low duty-cycle stimulation sufficient to treat chronic inflammation with progressively longer delays (off periods) from an initial stimulation. In particular, described herein are supra-threshold pulses of electrical stimulation sufficient to result in a long-lasting (e.g., >48 hours) inhibition of pro-inflammatory cytokines and/or effects of chronic inflammation; the delay between initial doses (which may be single-pulse doses) may be extended for subsequent doses, potentially dramatically enhancing battery and device longevity.

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: One aspect of the present disclosure relates to a system that can provide an incomplete nerve block to a patient. In some instances, the incomplete nerve block can be bi-directional. In other instances, the incomplete nerve block can be adjustable. The system can include a waveform generator that can provide temporary electrical nerve conduction block to a nerve using an electrode. The electrode can include at least one contact. The temporary electrical nerve conduction block can block conduction in less than 100% of the fibers within the nerve located in close proximity to or being surrounded by the electrode. The temporary electrical nerve conduction block does not cause intentional damage to neural tissue as mode of action to achieve the incomplete nerve block. A complete recovery of nerve conduction can be expected post application of the incomplete nerve block.

Abstract: Apparatus for driving fluid between first and second anatomical sites of a subject is provided, comprising (1) a first electrode, configured to be coupled to the first anatomical site of the subject; (2) a second electrode, configured to be coupled to the second anatomical site of the subject; and (3) a control unit, configured to (i) detect a pressure difference between the first and second anatomical sites, and (ii) in response to the detected pressure difference, drive fluid between the first and second anatomical sites by applying a treatment voltage between the first and second electrodes. Other embodiments are also described.

Abstract: A medical device includes a VNS pulse burst generator for stimulation of the vagus nerve, and a controller for analyzing the cardiac rhythm. It further includes a sequencer that uses an estimator to calculate during a given cycle an estimate of the temporal position of the R wave of the next cycle. The controller is configured to define the moment of application of the VNS pulse burst as an instant corresponding to the estimate minus a predetermined advance delay. VNS therapy is thus delivered in a non-vulnerable period, near the end of the period of natural ventricular escape.

Abstract: Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein.

Abstract: A mechanical locating tool for self-locating the supraclavicular fossa region of the human body to activate the brown adipose tissue depot therein by referencing at least one of the clavicle, chin, neck and/or sternum. Also, a method for activation of brown adipose tissue depot in a human body by partially implanting a body piercing object proximate a target area of the human body in which the brown adipose tissue depot is located. An electrical stimulation signal is applied to the partially implanted body piercing object to generate an electric field to activate the brown adipose tissue depot The partially implanted body piercing object may also serve as a mechanical locating tool for positioning of a transdermal electrical stimulation patch and/or serve as a conduit for providing a secondary source of electrical stimulation to a target area.

Abstract: A method comprises applying a first open-loop electrical signal to a neural structure at a first rate. The method also comprises applying a closed-loop electrical signal to the neural structure in response to an event detection, thus causing an overall rate at which electrical stimulation is applied to the neural structure to exceed the first rate. The method further comprises applying a second open-loop electrical signal to a neural structure at a second rate that is lower than the first rate, thus causing the overall rate to be reduced to the first rate.

Abstract: An implantable system includes at least one electrode that is configured to apply a stimulus to surrounding tissue based on a control signal. A control module provides the control signal, such as for controlling application of the stimulus, which can be an electrical stimulus, a chemical stimulus or a combination thereof. A detector is configured to detect a temperature characteristic associated with one or more of the electrode and the surrounding tissue. An output signal is provided based on the detected temperature characteristic. The output signal can be used by an associated diagnostic system to terminate a diagnostic procedure, such as to mitigate heating of the electrode and/or the surrounding tissue.

Abstract: An active implantable medical device includes a VNS pulse bursts generator for stimulation of the vagus nerve according to several selectable configurations. The device may further include a sensor of the current activity level of the patient. The generator is controlled on the activity signal via a classifier determining the of class the current level of activity among a plurality of classes of activity. A controller selects a configuration of VNS therapy depending on the class of activity thus determined. Limits of the activity classes are dynamically changeable by a calibration module that conducts a historical analysis of the successive current activity levels over a predetermined analysis period. The calibration module can prepare a histogram of the historical analysis, and can define the limits of the activity classes depending on the outcome of the historical analysis and the histogram.

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: Embodiments of the present invention relate to a non-invasive stimulatory adjustment of the body's own self-repair-system using a plurality of electrons. In particular, embodiments of the present invention relate to a plurality of electrons for use in the restoration of a patient's health, preferably a human patient's health in a number of medical conditions. Moreover, embodiments of the present invention relate to a method of treatment using a plurality of electrons for use in the restoration of a patient's health, preferably a human patient's health. Moreover, embodiments of the present invention relate to a method of stimulatory adjustment of the body's own self-repair system using a plurality of electrons.

Abstract: The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

Abstract: An implantable nerve stimulation device has a sensor system, a data processor in communication with the sensor system, and a nerve stimulation system in communication with the data processor and constructed to provide electrical stimulation to at least one branch of at least one vestibulocochlear nerve. The nerve stimulation system includes an electrode array that has a first plurality of electrodes structured to be surgically implanted in electrical communication with a superior branch of the vestibular nerve, a second plurality of electrodes structured to be surgically implanted in electrical communication with a horizontal branch of the vestibular nerve, a third plurality of electrodes structured to be surgically implanted in electrical communication with a posterior branch of the vestibular nerve, and a common erus reference electrode structured to be surgically implanted into a common eras of the vestibular labyrinth.

Abstract: An energy-releasing carbon nanotube transponder comprising a nanocapacitor connected to at least one carbon nanotube and method of using same are described. An adjustable amount of electric energy is stored within the nanocapacitor so that the energy-releasing carbon nanotube transponder delivers either a biologically destructive or a biologically non-destructive electrical charge to target cells in response to biological, chemical or electrical stimuli. An optional biocompatible coating onto the outer surface of the carbon nanotube transponder improves cellular targeting, cellular binding or body tolerance towards the carbon nanotube transponder. Optionally, a molecular label attached to at least one carbon nanotube allows for in vivo tracking of the carbon nanotube transponder.

Abstract: A preferred frequency is identified, being usable to stimulate a neurological target within a mammalian body using at least one microelectrode positioned at or near the target. To establish efficient and effective stimulation, an impedance analyzer is provided for measuring electrical impedance values indicative of a microelectrode-tissue interface across a range of different frequencies. A preferred one of the measured electrical impedance values is identified as being closest to a pure resistance. The neurological target can then be stimulated at or near the frequency associated with the preferred impedance value (peak resistance frequency), thereby promoting desirable traits, such as optimum charge transfer, minimum signal distortion, increased stimulation efficiency, and prevention of microelectrode corrosion. The peak resistance frequency can be used to determine an preferred pulse shape.

Abstract: Embodiments relate to a device for controlling delivery of stimulation signals, comprising: a stimulation delivery circuit; a monitoring component to monitor voltage supplied in at least one current-driven charge pulse via the stimulation delivery circuit; and a stimulation control component to control voltage supplied in at least one subsequent charge pulse based on the charge of the at least one charge pulse delivered by the stimulation delivery circuit. The device may further comprise a model generation component to generate an impedance model of stimulation electrodes in the stimulation delivery circuit, wherein the stimulation control component is configured to control the stimulation delivery circuit to deliver charge according to the impedance model.

Abstract: A device for keeping awake a person that is about to fall asleep is proposed, comprising a pair of glasses with a frame that has two arms, at least one sensor for detecting the movements of an eye blink, at least one battery, and at least one electrode for issuing an electric pulse.

Abstract: Apparatus is provided, including (1) an external device, configured for placement outside of a body of a subject and to sense a factor of the subject, and to generate a signal in response to the sensed factor, and (2) an implant, which comprises a wireless receiver for receiving the signal, and at least one electrode, the implant configured to drive the electrode to apply current to an aortic and/or vagal site of the subject in response to the signal.

Abstract: A method for determining a desired location at which to apply a neural therapy. An array of electrodes is positioned proximal to neural tissue. A stimulus is applied from the array which evokes a neural compound action potential response in the neural tissue proximal to the array. A plurality of electrodes of the array simultaneously obtain respective measurements of the neural compound action potential response. From the measurements of the neural compound action potential response a desired location for a neural therapy is determined.

Abstract: A neural stimulation system automatically corrects or adjusts the stimulus magnitude (stimulation energy) in order to maintain a comfortable and effective stimulation therapy. Because the changes in impedance associated with the electrode-tissue interface can indicate obstruction of current flow and positional lead displacement, lead impedance can indicate the quantity of electrical stimulation energy that should be delivered to the target neural tissue to provide corrective adjustment. Hence, a change in impedance or morphology of an impedance curve may be used in a feedback loop to indicate that the stimulation energy needs to be adjusted and the system can effectively auto correct the magnitude of stimulation energy to maintain a desired therapeutic effect.

Abstract: Apparatus is configured to drive first action potentials orthodromically in a first direction along a nerve of a subject, and second action potentials orthodromically along the nerve in an opposite direction to the first direction. The apparatus includes: (1) first and second excitation units configured to be placed in a proximity of the nerve of the subject; (2) a blocking unit disposed between the excitation units and placeable in a proximity of the nerve of the subject; and (3) a control unit, configured: (i) to drive the first and second excitation units to apply, respectively, first and second excitatory currents to the nerve of the subject, and (ii) to drive the blocking unit to apply a blocking current to the nerve of the subject that blocks action potentials that propagate from the first and second excitatory units toward the blocking unit. Other embodiments are also described.

Abstract: An implantable device (100) having an electronic component (110) and a biologic materials component (130). The biologic materials component has target cells in a matrix that interfaces the electronic component with the surrounding environment.

Abstract: A lead for an implantable cardiac prosthesis having an integrated protection against the effects of magnetic resonance imaging (“MRI”) fields. A protection circuit (26) may be placed at the distal end of the lead comprises a resistive component (28) interposed between the electrode (E1, E2) and the distal end of the conductor (22, 24) associated with this electrode. A normally-open controlled active switch (34, 36) may allow in its closed state to short-circuit the resistive component. A control stage (32) may be coupled to the conductors and detect the voltage of a stimulation pulse applied on the conductor(s), and selectively control by this voltage the closing of the active switch for a duration at least equal to the duration of detected stimulation pulse.

Abstract: The present invention provides a closed-loop system for treating neurological disorders, such as epilepsy. In one embodiment the system comprises an input assembly that is adapted to receive one or more signals from a patient that are indicative of a patient's neurological state. The input assembly processes the one or more signals to generate one or more control input signals. An output assembly receives the one or more control input signals from the input assembly and generate a neuromodulation signal that is a function of the patient's neurological state. An electrode array is configured to deliver the neuromodulation signal to a patient's peripheral nerve, such as the vagus nerve.

Abstract: Described herein are methods, devices, and systems for treating human anemia. The methods, devices, and systems generally include monitoring a patients hemoglobin level and at least one of autonomic balance and inflammatory state to determine the etiology of the anemic state, modulating at least one of a sympathetic or parasympathetic nerve based on the cause of the anemia, monitoring for changes in the patients cardiac activity and state of inflammation, and hemoglobin level. An external neurostimulation system is describes, and well as a chronic implantable system. A method for treating a patient for anemia in conjunction with a renal denervation ablation catheter is also disclosed.

Abstract: The present invention relates a method of treating heart failure in patients with coincident atrial fibrillation, the method comprising: screening of patients for selection of potential responders to neurostimulation based on heart rate variability; implanting a neurostimulator device around a vagus nerve in the selected patients followed by stimulating the vagus nerve at an electrical stimulus intensity below threshold for heart rate reduction; and remotely monitoring and controlling the neurostimulator based on cardiac health parameters of the patient subjected to vagal nerve stimulation.

Abstract: A method and apparatus for neural stimulation are disclosed. The principle is that a conventional current path is used to deliver the stimulus to neural structures, but an alternative current path is provided to bypass the neural structures during the opposite polarity part of the current flow. As a consequence, charge balance can be provided at the tissue/electrode interface, whilst delivering stimuli which are not charge balanced to the neural structures.

Abstract: An apparatus for the prevention of decubitus ulcers includes an overlay and a plurality of stimulation segments disposed throughout the overlay, wherein the stimulation segments provide stimulation. At least one sensor is disposed within at least one of the plurality of stimulation segments. A controller is electrically connected to the at least one sensor, wherein the controller gathers data from the sensor, processes the data, and transmits instructions to the stimulation segments.

Abstract: Systems and methods are described for subject rehospitalization management. In an example, multiple physiologic signals can be obtained from a subject using multiple sensors. In response to a hospitalization event, pre-hospitalization characteristics of the multiple physiologic signals can be identified. Post-hospitalization characteristics of the multiple physiologic signals can be identified, including characteristics that differ from their corresponding pre-hospitalization characteristics. Later subsequent physiologic signals can be further monitored after the hospitalization event, such as using the same multiple sensors, and subsequent physiologic signal characteristics can be identified. In an example, a heart failure diagnostic indication can be determined using information about the pre-hospitalization characteristics, the post-hospitalization characteristics, and the subsequent characteristics.

Abstract: A system and method for estimating the current delivered to a patient during voltage-regulated electrical stimulation therapy by an implantable medical device includes calculating a total charge delivered and a peak current delivered and the time at which the peak current was delivered using a proxy for the current delivered to the patient and a component such as a current controlled oscillator, the output of which is proportional to the current proxy together with memory for storing values relating to the output proportional to the current proxy. The stored values also may be used to construct a waveform approximating the current delivered to the patient during a therapy of voltage-regulated stimulation. The system and method may be implemented in an active implantable medical device such as an implantable neurostimulator.

Abstract: Electrode voltage monitoring circuitry for an implantable neurostimulator system having a plurality of electrode-driver integrated circuits (ICs) in provided. Electrodes from either or both ICs can be chosen to provide stimulation, and one of the IC acts as the master while the other acts as the slave. Electrodes voltages on the slave IC are routed to the master IC, and thus the master IC can monitor both electrode voltages on the slave as well as electrode voltages on the master. Such voltages can be monitored for a variety of purposes, and in particular use of such voltage is disclosed for determining the resistance between electrodes and to set a compliance voltage for stimulation.

Abstract: A method and system for differential analysis of cardiac events are provided that include monitoring cardiac signals from a heart to detect deviations indicative of at least one of ischemia and myocardial infarction (MI). The method and system also monitor physiologic surrogate signals associated with pain to detect chest pain. Additionally, the method and system include characterizing a cardiac event exhibited by the heart based on whether the cardiac event occurs in a presence of at least one of the ischemia, IM, and chest pain.

Abstract: A system and method for automatically adjusting the value of a parameter defined to manage and control the resources recruited by an implantable medical device to supply power or the device to deliver an instance of an electrical stimulation therapy to a patient. In embodiments, the parameter corresponds to a number of capacitors the discharge of which supplies the power to deliver a stimulation therapy at a programmed amplitude. Whenever the circumstances prevent the programmed amplitude from being delivered, the system and method automatically adjust the resource-controlling parameter to use the minimum power to achieve the desired (programmed) amplitude or as close as possible to that programmed amplitude. Some embodiments additionally include using another parameter (a equivalent amplitude parameter) to balance the charge delivered through multiple pathways in parallel sourced from a single reservoir of power.

Abstract: A method and system for deriving effectiveness of medical treatment of a patient are provided that include collecting patient state (PS) data from at least one of an implantable medical device (IMD) or an external medical device (EMD) over a collection interval. The collected PS data relates to a physiologic characteristic (PC) of the patient. The PS data is transferred to a database that is remote from the patient to form a patient state data (PSD) history. The patient undergoes a pivotal medical event (PME) during the collection interval. The PS data within the PSD history is analyzed before and after the PME to propose a treatment therapy (TT). Following delivery of the TT, the collecting and transferring operations are repeated to obtain post-treatment PS data and form a post-treatment PSD history. An effectiveness indicator (EI) of the TT is derived based on at least the post-treatment PSD history.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Abstract: Devices and methods for detecting meal intake are disclosed herein. In some embodiments, one or more sensors can be used to detect or monitor physiological parameters of a user (e.g., heart rate, body movements, temperature, pH, impedance, gastric stretch, sound emissions, and the like). The outputs of the sensors can be received by a computer system configured to analyze the sensor data and make a determination as to whether meal intake has occurred or is presently occurring. The computer system's determination can be used to trigger, modulate, or otherwise control one or more therapeutic devices. Other types of devices can also be controlled using this determination, such as monitoring or logging devices.

Abstract: A system and method include a processor that, based on at least a subset of stored data of clinical effects of one or more stimulations of anatomical tissue performed using electrodes of an implanted leadwire, generates and outputs at least one graphical marking representing the at least the subset of the stored data. Each of the at least one graphical marking represents a respective portion of the at least the subset of the stored data and is output in association with a respective set of values for each of at least two parameters by which one or more the stimulations were performed. The markings are plotted in a graph defined by axes corresponding to values of respective stimulation parameters. Alternative, the markings are arranged in a column of a tabular report. The markings are two-toned to provide respective information for both therapeutic and adverse side effects.

Abstract: A method and apparatus for using low levels of electrical stimulation to treat spasmodic dysphonia by stimulating the afferent nervous system and/or altering the function of gamma motor neurons innervating muscles which experience symptomatic spasms.

Abstract: A vagus nerve is efficiently stimulated while preventing wasteful energy consumption. Provided is a nerve stimulating device (1) including a stimulation-signal outputting portion (3) that outputs a stimulation signal to a vagus nerve (B); a heart-event detecting portion (2) that detects a heart event; and a control portion (4) that makes a judgment regarding the responsiveness of a heart (A) based on the heart event detected by the heart-event detecting portion (2) in response to the stimulation signal output from the stimulation-signal outputting portion (3), and that controls the stimulation-signal outputting portion (3) so that an intensity of the stimulation signal is decreased when the responsiveness of the heart (A) is decreased.

Abstract: A system for the control of an implant (32) in a body (11), comprising first (10, 20) and second parts (12) which communicate with each other. The first part (10, 20) is adapted for implantation and for control of and communication with the medical implant (32), and the second part (12) is adapted to be worn on the outside of the body (11) in contact with the body and to receive control commands from a user and to transmit them to the first part (10, 20). The body (11) is used as a conductor for communication between the first (10, 20) and the second (12) parts. The second part (12) is adapted to receive and recognize voice control commands from a user and to transform them into signals which are transmitted to the first part (10, 20) via the body (11).

Abstract: An apparatus (40) comprises means (402) for applying electrical stimulation to a human or animal body via a pair of electrodes (50). The apparatus further comprises means (406, 410) for measuring impedance of the body between the pair of electrodes (50).

Abstract: Systems and methods for modulating a physiological process are provided to enable precise delivery of signals to a predetermined treatment site. The systems may comprise an implantable device and an electrical lead body. The electrical lead body may comprise a plurality of transducer contacts in close proximity to an end of the electrical lead body, and a control unit positioned within the lead body in close proximity to the plurality of transducer contacts.

Abstract: Systems and methods for modulating a physiological process are provided to enable precise delivery of signals to a predetermined treatment site. The systems may comprise an implantable device and an electrical lead body. The electrical lead body may comprise a plurality of transducer contacts in close proximity to an end of the electrical lead body, and a control unit positioned within the lead body in close proximity to the plurality of transducer contacts.

Abstract: The disclosure describes a system that measures the distance between one or more electrodes and tissue of a patient, and controls one or more parameters of the stimulation delivered to the tissue by the electrodes based on the measured distance. The system controls the measurement of the distance between the electrodes and the tissue as a function of activity of the patient. The system uses, for example, a piezoelectric transducer to sense activity of the patient, and may determine whether or how frequently to measure the distance between electrodes and tissue based on the sensed physical activity. A piezoelectric transducer may be used both to sense activity and to measure the distance between the electrodes and the tissue.

Abstract: At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.