Abstract: An example of a neurostimulation system may include a storage device, a programming control circuit, and a graphical user interface (GUI). The storage device may be configured to store individually definable waveforms. The programming control circuit may be configured to generate stimulation parameters controlling the delivery of the neurostimulation pulses according to a pattern. The GUI may be configured to define the pattern using one or more waveforms selected from the individually definable waveforms. The GUI may display waveform tags each selectable for access to a waveform of the individually definable waveforms, and display a waveform builder in response to selection of one of the waveform tags. The waveform builder may present a graphical representation of the accessed waveform and allow for the accessed waveform to be adjusted by editing the graphical representation of the accessed waveform on the GUI.

Abstract: An implantable electrical stimulation lead includes at least three modular lead elements configured to couple together to form the lead, each of the modular lead elements including a proximal end portion, a distal end portion, and a male connector element or a female connector element disposed on at least one of the proximal end portion or the distal end portion of the modular lead element, The modular lead elements are coupleable together by insertion of a male connector element into a female connector element.

Abstract: A neuromodulation system comprises a plurality of electrical terminals configured for being respectively coupled to a plurality of electrodes, a user interface configured for receiving input from a user that selects one of a plurality of different shapes of a modulating signal and/or selects one of a plurality of different electrical pulse parameters of an electrical pulse train, neuromodulation output circuitry configured for outputting an electrical pulse train to the plurality of electrical terminals, and pulse train modulation circuitry configured for modulating the electrical pulse train in accordance with the selected shape of the modulating signal and/or selected electrical pulse parameter of the electrical pulse train.

Abstract: Systems and techniques are disclosed to establish programming of an implantable electrical neurostimulation device for treating pain of a human subject, through the use and adjustment of analgesic stimulation parameters based on trust dynamics and trust measurements. In an example, the system to establish programming of the neurostimulation device performs operations that: determine a trust measurement value that is derived from results of at least one commitment made with a human subject, via observable interactions; determine a modification of at least one neurostimulation programming parameter, based on the trust measurement value; and to cause the implantable neurostimulation device to implement the modification of the at least one neurostimulation programming parameter. Further examples are provided to produce and track the trust measurement value, as well as identify a pain susceptibility value and determine a receptiveness to analgesic effects based on these and other trust dynamics.

Abstract: A medical device kit includes a tunneling tool configured to form a tunnel through patient tissue for receiving an electrical stimulation lead. The tunneling tool includes a tunneling-tool body having an elongated shape with a proximal portion and a distal portion. The tunneling-tool body is formed from a material configured to be manually bent prior to insertion into patient tissue to conform to an anatomical contour through which the tunnel is to extend. A blunt tip is disposed at the distal portion. The blunt tip is configured to tunnel through patient tissue. A tunneling-tool suture-receiving element is disposed along the proximal portion of the tunneling-tool body. The tunneling-tool suture-receiving element is configured to receive a suture extendable along the tunnel formed by the tunneling tool.

Abstract: A new architecture is disclosed for an IPG having a master and slave electrode driver integrated circuits (ICs). The electrode outputs on the ICs are wired together. Each IC can be programmed to provide pulses with different frequencies. Active timing channels in master and slave ICs are programmed to provide the desired pulses, while shadow timing channels in the master and slave are programmed with the timing data from the active timing channels in the other IC so that each chip knows when the other is providing a pulse, so that each chip can disable its recovery circuitry so as not to defeat those pulses. In the event of pulse overlap at a given electrode, the currents provided by each chip will add at the affected electrode. Compliance voltage generation is dictated by an algorithm to find an optimal compliance voltage even during periods when pulses are overlapping.

Abstract: This document discusses, among other things, systems and methods to map an electrical waveform to a user-perceivable input. Some system examples include at least one electrode configured to sense neural activity in a patient, a mapping controller configured to receive an electrical waveform from the at least one electrode and map the sensed neural activity to a user-perceivable output based on the sensed neural activity, and a user interface operably connected to the mapping controller and configured to provide the user-perceivable output to a user.

Abstract: An electrical stimulation system includes a control module that provides electrical stimulation signals to an electrical stimulation lead coupled to the control module for stimulation of patient tissue. The system also includes a sensor to be disposed on or within the body of the patient and to measure a biosignal; and a processor to communicate with the sensor to receive the biosignal and to generate an adjustment to one or more of the stimulation parameters based on the biosignal. The adjustment can be configured and arranged to steer the electrical stimulation signals to stimulate a region of the patient tissue that is different, at least in part, from a region of the patient tissue stimulated prior to the adjustment. Alternatively or additionally, the biosignal is indicative of a particular patient activity and the adjustment is a pre-determined adjustment selected for the particular patient activity.

Abstract: An algorithm programmed into the control circuitry of a rechargeable-battery Implantable Medical Device (IMD) is disclosed that can adjust the charging current (Ibat) provided to the rechargeable battery over time (e.g., the life of the IMD) in accordance with one or more of the parameters having an effect on rechargeable battery capacity, such as number of charging cycles, charging current, discharge depth, load current, and battery calendar age. The algorithm consults such parameters as stored over the history of the operation of the IMD in a parameter log, and in conjunction with a battery capacity database reflective of the effect of these parameters on battery capacity, estimates a change in the capacity of the battery, and adjust the charging current in one or both of trickle and active charging paths to slow the loss of battery capacity and extend the life of the IMD.

Abstract: A system and method for securing a medical implant within a patient includes disposing an anchor element around the implant, the anchor element including a pair of tabs each including an eyelet, and a flexible intermediate portion between the tabs, by positioning the implant within the intermediate portion and folding the anchor element such that the tabs contact one another. The anchor element is positioned at a desired implantation position with the tabs proximate soft tissue of the patient. The method further includes inserting a distal tip of a fixation element delivery tool through the eyelets and into the soft tissue, the fixation element including at least one tissue anchor and an adjustable suture arrangement coupled to the tissue anchor. The tissue anchor is deployed from the delivery tool and into the soft tissue of the patient. The delivery tool is withdrawn and the adjustable suture arrangement is tightened.

Abstract: This document discusses, among other things, systems and methods for programming neuromodulation therapy to treat neurological or cardiovascular diseases. A system includes an input circuit that receives a modulation magnitude representing a level of stimulation intensity, a memory that stores a plurality of gain functions associated with a plurality of modulation parameters, and a electrostimulator that may generate and deliver an electrostimulation therapy. A controller may program the electrostimulator with the plurality of modulation parameters based on the received modulation magnitude and the plurality of gain functions, and control the electrostimulator to generate electrostimulation therapy according to the plurality of modulation parameters.

Abstract: This document discusses, among other things, systems and methods for delivering electrostimulation to specific tissue of a patient. An example of a system can receive a three-dimensional voxelized model representing a plurality of regions each specified as a target region or an avoidance region. The system includes control circuitry to determine a metric value using the voxelized model. The metric value indicates a clinical effect of electrostimulation on the plurality of regions according to a stimulation current and a current fractionalization. The control circuitry can determine a desired stimulation current that results in a first metric value satisfying a clinical effect condition. The system can generate a stimulation configuration including the desired stimulation current and the current fractionalization corresponding to the first metric value, and deliver tissue stimulation according to the stimulation configuration.

Abstract: Techniques for determining the trajectory of a one or more dorsal roots and utilizing the trajectories to improve a spinal cord stimulation model are disclosed. A first improvement constructs a target stimulation field along a path that is parallel with the determined trajectory that is nearest to a specified desired location of stimulation. An allocation of stimulation among the electrodes to mimic the target field is computed. A second improvement models a response of neural elements at evaluation positions that are parallel with the trajectories based on the electric field that is generated for the computed allocation of stimulation among the electrodes. The stimulation amplitude is adjusted based on the neural element modeling to maintain stimulation intensity, and the stimulation amplitude and allocation of stimulation among the electrodes are compiled into an electrode configuration that is communicated to a neurostimulator.

Abstract: A method for implanting a lead includes inserting a needle into the patient; inserting a lead blank through the needle; steering the lead blank to, or near, a lead implantation site; removing the needle from the patient and leaving the lead blank; advancing a flexible sheath over the lead blank after removing the needle; removing the lead blank from the patient and leaving the flexible sheath; inserting a lead through the flexible sheath, after removing the lead blank, and implanting the lead at the lead implantation site; and removing the flexible sheath. The flexible sheath can also be used for explanting a lead and, optionally, implanting a new lead.

Abstract: An electrical stimulation lead includes terminals disposed along the proximal portion of the electrical stimulation lead; segmented electrodes disposed along the distal portion of the electrical stimulation lead; conductors electrically coupling the terminals to the electrodes; and an electrode carrier with divider segments extending from shoulder segments and disposed between, and separating, at least two of the segmented electrodes. The electrical stimulation lead can be formed by disposing electrode strips on an electrode carrier, each of the electrode strips comprising a plurality of pre-electrodes and at least one connection region in an alternating, longitudinal arrangement with one of the at least one connection region disposed between each adjacent pair of the pre-electrodes of the electrode strip; and removing each of the connection region(s) to separate the pre-electrodes into segmented electrodes.

Abstract: An implantable electrical lead is provided. The electrical lead comprises an electrically insulative, flexible, elongated lead body having a proximal end and a distal end, an electrical contact carried by the distal end of the lead body, an electrical terminal carried by the proximal end of the lead body, an electrical conductor axially extending within the lead body between the electrical contact and the electrical terminal, and a stiffening tube extending within the proximal end of the lead body from a point proximal to the terminal to a point distal to the terminal and proximal to the electrode. An implantable lead assembly kit comprises the implantable electrical lead, and a connector configured for firmly receiving the proximal end of the lead body. A method of implanting the electrical lead comprises introducing the electrical lead into a patient.

Abstract: A system or method for identifying sets of stimulation parameters can include receiving at least one image of a region of a patient; registering the at least one image with an anatomical or physiological atlas that identifies different anatomical or physiological structures; identifying a desired stimulation region using the at least one image; comparing the desired stimulation region with each of a plurality of predetermined estimated stimulation regions, where each of the estimated stimulation regions is a calculated estimate of a stimulation volume for a corresponding set of electrical stimulation parameters; selecting one of the predetermined estimated stimulation regions based on the comparing; and providing the corresponding set of electrical stimulation parameters for the selected one of the predetermined estimated stimulation regions to a user or an electrical stimulation device.

Abstract: An implantable stimulator device is disclosed for executing a stimulation program comprising a plurality of sub-programs, wherein the sub-programs are configured to be automatically sequentially executed by stimulation circuitry in the device. Control circuitry periodically stores log data to indicate where each sub-program is in its execution. If the device experiences an interruption that prevents the stimulation circuitry from executing the stimulation program, and upon receiving an indication that the stimulation circuitry can continue execution of the stimulation program, the control circuitry is configured to query the log data to determine a sub-program during which the interruption occurred, and using the log data, cause the stimulation circuitry to continue execution of the stimulation circuitry either at the beginning of the sub-program, or at a point during the sub-program when the interruption occurred.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for delivering therapy to an adrenal gland of a patient. The apparatuses, systems, and methods may include a plurality of stimulation elements arranged configured to deliver stimulation energy through at least one of the plurality of stimulation elements to modulate aldosterone levels within the patient.

Abstract: A method for manufacturing a lead includes forming an elongated multi-lumen conductor guide defining a central stylet lumen and a plurality of conductor lumens arranged around the stylet lumen. The multi-lumen conductor guide is twisted to form at least one helical section where the plurality of conductor lumens each forms a helical pathway around the stylet lumen. Each of the helical pathways of the at least one helical section has a pitch that is no less than 0.04 turns per centimeter.