Abstract: Devices and methods for treating obstructive sleep apnea by first performing an assessment of the patient that involves observing the patient's upper airway during a tongue protrusion maneuver. The assessment may, for example, be done using endoscopy to observe the upper airway while the patient is awake in the supine position. An adequate response of the upper airway during the tongue protrusion maneuver is indicative of likely therapeutic success with hypoglossal nerve stimulation, and may be used for making clinical decisions. The principles of the present invention may be applied to other therapeutic interventions for OSA involving the upper airway.

Abstract: Multi-modal stimulation therapy may be utilized in which two or more stimulation therapies having different stimulation parameters may be delivered to a single patient. This can preferentially stimulate different nerve fiber types and drive different functional responses in the target organs. The stimulation parameters that may vary between the different stimulation therapies include, for example, pulse frequency, pulse width, pulse amplitude, and duty cycle.

Abstract: Systems and methods for customizable titration of an implantable neurostimulator are provided. A method of titrating a neurostimulation signal delivered to a patient from an implantable pulse generator includes delivering a first neurostimulation signal with a first set of parameters, increasing a first value of the first neurostimulation signal at a first rate for a first period of time while delivering the first neurostimulation signal, ceasing delivery of the first neurostimulation signal when the first value reaches a first target value, delivering a second neurostimulation signal with a second set of parameters, and increasing the second neurostimulation signal at a second rate for a second period of time while delivering the second neurostimulation signal.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. The implanted stimulation device includes a physiological sensor for recording the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time.

Abstract: Systems and methods for a user interface for titration of an implantable neurostimulator are provided. A method of managing titration using a management device for a patient implanted with a neurostimulator includes receiving, from the neurostimulator, data for the patient relating to stimulation being provided to the patient by the neurostimulator while the neurostimulator is in communication with the management device, displaying a user interface on a display of the management device, the user interface including at least a portion of the data displayed within a graph, the user interface allowing a user to modify a parameter of the titration, receiving a selection of the parameter, based on the selection, determining a titration schedule for the patient, and transmitting the titration schedule to the neurostimulator.

Abstract: A cannula fixation device includes a base having a platform; a subject-interface portion having an upper surface and a lower surface, the upper surface coupled to the base and the lower surface configured to be coupled to a subject; and a clip assembly configured to retain a portion of a cannula. The clip assembly is moveably coupled to the base such that the clip assembly can be selectively positioned in a first position relative to the base or a second position relative to the base.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. Stimulation from an implantable medical device (IMD) may be suspended in response to detecting a patient discomfort event, such as a cough, throat irritation, or voice alteration. The suspension period may be based on at least one of a severity level of the patient discomfort event and a patient physical state, such as being asleep or lying down. Detection of a patient discomfort event may be calibrated.

Abstract: A medical device includes a pulse generator and a filter. The pulse generator is configured to generate a stimulation signal and to provide the stimulation signal to tissue of a patient via an implantable lead assembly. The filter is configured to couple to the implantable lead assembly. A combined impedance of the implantable lead assembly and the filter with respect to a current induced by an external electro-magnetic field satisfies an impedance threshold when the external electro-magnetic field has a first frequency and when the external electro-magnetic field has a second frequency. The combined impedance has a peak impedance value when the external electro-magnetic field has a third frequency that is between the first frequency and the second frequency.

Abstract: Systems and methods are provided for delivering neurostimulation therapies to patients. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level until a target T-wave alternans change from a baseline T-wave alternans is achieved.

Abstract: Devices and methods for improving the coupling between the soft palate and the genioglossus. This may be accomplished, for example, but shortening or stiffening the palatoglossal arch. Improved coupling between the soft palate and the genioglossus may be beneficial to a patient suffering from obstructive sleep apnea (OSA) as a stand-alone procedure, or in combination procedures and devices that cause anterior displacement of the tongue such as hypoglossal nerve stimulation, genioglossus advancement surgery, mandibular advancement surgery, mandibular advancement (oral) appliances, etc.

Abstract: A method including chronically implanting a nerve cuff electrode on a portion of a hypoglossal nerve, chronically implanting a respiration sensing lead subcutaneously in a thorax of a patient, the respiration sensing lead having a plurality of bio-impedance electrodes defining at least one bio-impedance vector. The method may also include sensing a bio-impedance signal corresponding to respiration via a bio-impedance vector on an anterior side of the thorax, analyzing the bio-impedance signal to identify onsets of expiration, predicting an onset of a future expiratory phase, and delivering a stimulus to the portion of the hypoglossal nerve via the nerve cuff electrode, wherein the stimulus is delivered as a function of the bio-impedance signal; wherein stimulus delivery is initiated before the onset of the future expiratory phase and continued during an entire inspiratory phase, and wherein the method is performed without identifying an onset of an inspiratory phase.

Abstract: An implantable neurostimulation system comprises a stimulation delivery lead and a neurostimulator. The stimulation delivery lead is coupled to an electrode. The neurostimulator is adapted to deliver a neurostimulation signal to the subject and comprises a microprocessor. The microprocessor is programmed to identify a stimulation operating window for the therapy including a first threshold and a second threshold. The second threshold comprises an awake level and an asleep level. Identifying the stimulation operating window comprises titrating a stimulation setting of the neurostimulator while the subject is awake until the first threshold and the awake level of the second threshold are identified. Identifying the stimulation operating window further comprises subsequently repeating the step of titrating the stimulation setting of the neurostimulator while the subject is asleep until the asleep level of the second threshold is identified.

Abstract: Devices, systems and methods of neurostimulation for treating obstructive sleep apnea.

Abstract: Systems and methods are provided for delivering vagus nerve stimulation and carotid baroreceptor stimulation to patients for treating chronic heart failure and hypertension. The vagus nerve stimulation and carotid baroreceptor stimulation therapies may be provided using a single implantable pulse generator, which can coordinate delivery of the therapies.

Abstract: According to aspects of the present disclosure, an implantable pulse generator includes a housing, a header, and a retainer device. The housing includes circuitry and a battery. The header is coupled to the housing and includes a bore configured to receive an end of a lead, and a passage disposed transverse to the bore and extending between an exterior surface of the header and an anchor cavity that extends into the header from the bore. The header supports at least one electrical contact within the bore coupled to the circuitry. The retainer device includes a looped member arranged within the bore, a proximal end extending at least partially into the passage, and anchored at a distal end by the anchor cavity.

Abstract: The present disclosure relates to a method for modulating the nervous system in order to reduce inflammation. The method includes delivering a vagus nerve stimulation (VNS) therapy to a vagus nerve of a patient for the treatment of inflammation according to a first set of parameters. The method further includes delivering a secondary nerve stimulation (SNS) therapy to a secondary nerve of the patient for the treatment of a sleep disorder according to a second set of parameters different from the first set of parameters.

Abstract: Disclosed herein are methods, systems, and apparatus for treating a medical condition in a patient using an implantable medical device (IMD). The IMD is capable of generating a first electrical signal for treating a medical condition, for example epilepsy. The first electrical signal relates to a long term therapy during a first time period in which there is no indication that the patient's brain is in an stable state, the first electrical signal being a microburst stimulation signal. The implantable device is also capable of generating a second electrical signal for treating the medical condition. The second electrical signal relates to a short term therapy during a second time period, in response to an indication that the patient's brain is in an unstable state. The second electrical signal in one example, may be a conventional stimulation signal.

Abstract: Systems and methods are provided for delivering vagus nerve stimulation and carotid baroreceptor stimulation to patients for treating chronic heart failure and hypertension. The vagus nerve stimulation and carotid baroreceptor stimulation therapies may be provided using a single implantable pulse generator, which can coordinate delivery of the therapies.

Abstract: Devices, systems and methods for nerve stimulation for OSA therapy.

Abstract: In one embodiment, a method for maintaining patency of an upper airway of a patient to treat obstructive sleep apnea may include delivering an electrical stimulation to a portion of a superior laryngeal nerve via a nerve cuff when the nerve cuff is adjacent an external surface of the superior laryngeal nerve, the nerve cuff having a plurality of electrodes, wherein the nerve cuff is configured to be connected to an electrical stimulator via a stimulation lead.