Abstract: An apparatus comprises a cardiac signal sensing circuit configured for coupling electrically to a plurality of electrodes and to sense intrinsic cardiac activation at three or more locations within a subject's body using the electrodes; a stimulus circuit configured for coupling to the plurality of electrodes; a signal processing circuit electrically coupled to the cardiac signal sensing circuit and configured to determine a baseline intrinsic activation vector according to the sensed intrinsic cardiac activation; and a control circuit electrically coupled to the cardiac signal sensing circuit and stimulus circuit and configured to: initiate delivery of electrical pacing therapy using initial pacing parameters determined according to the baseline intrinsic activation vector; initiate sensing of a paced activation vector; and adjust one or more pacing therapy parameters according to the paced activation vector.

Abstract: A system for performing a sleep study includes an implant able medical device (IMD) having a first sensor configured to obtain a first physiological parameter signal; a second sensor configured to obtain a second physiological parameter signal; and at least one processing device. The at least one processing device is configured to: receive the first physiological parameter signal and the second physiological parameter signal; and identify, based on a set of episode data, an occurrence of an episode during a sleep session, the episode corresponding to a sleep disorder, the set of episode data based on at least one of the first physiological parameter signal and the second physiological parameter signal. The at least one processing device is further configured to generate, based on the first physiological parameter signal and the second physiological parameter signal, a study report, the study report comprising an indication of the episode.

Abstract: An example of a system comprises a patch of electrodes for placement on tissue containing neural tissue, and a tissue tester configured to measure an electrical characteristic of tissue. The tissue tester may include a test controller and switches. The test controller and the switches may be configured to connect different combinations of the electrodes to create subsets of two or more electrodes to measure the electrical characteristic of tissue using the subsets. The test controller may be configured to measure an electrical characteristic of tissue using the subsets within the set of electrodes placed on the tissue, and compare measurements of the electrical characteristic and identify a neural target for a therapy based on the comparison of the measurements of the electrical characteristic for tissue at the neural target relative to adjacent non-neural tissue.

Abstract: A method of optimizing the electrical stimulation of a bladder of a patient including selecting a first subset of electrodes from a set of electrodes positioned adjacent to a set of nerves associated with the bladder. The set of electrodes may include one or more electrodes, each of which may be configured to deliver electrical stimulation pulses generated by a stimulator device to the nerves. The method may further include delivering an electrical stimulation pulse through the selected first subset of electrodes and recording at least one parameter of the electrical stimulation pulse after receiving patient feedback.

Abstract: An apparatus for coupling to a plurality of electrodes implantable at a plurality of tissue sites of a heart chamber of a subject. The apparatus including a stimulus circuit configured to provide an electrical cardiac pacing stimulation to the plurality of electrodes, a switching circuit configured to select electrodes of the plurality of electrodes for electrical coupling to the stimulus circuit, and a control circuit including a heart rate sub-circuit configured to determine heart rate; and a pacing site activation sub-circuit configured to selectively change which electrodes of the plurality of electrodes are used to provide the electrical cardiac pacing stimulation therapy according to the determined heart rate.

Abstract: An implantable medical device (IMD) system communicates to a user information regarding the surrounding biological environment and the influence of that surrounding biological environment on IMD functionality. This influence can be static or dynamic. Providing information on the biological environment can assist the user in determining therapy parameters for an individual patient with an IMD.

Abstract: A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity.

Abstract: A system includes an implantable medical device configured to sense a sync signal and sense physiological parameters to obtain a physiological signal. In response to sensing the sync signal, the implantable medical device is configured to generate a sync-stamped physiological signal. In certain embodiments, a method includes receiving a first physiological signal coupled with a sync signal; receiving a second physiological signal coupled with the sync signal; and, using the sync signal, synchronizing in time the first and second physiological signals.

Abstract: Embodiments of the disclosure include systems and methods for obtaining high-resolution data from implantable medical devices (IMDs) by triggering a limited-time system behavior change. For example, embodiments include utilizing study prescriptions for batching data obtained by an IMD, communicating the batched data to an external device, and reconstructing the batched data at the external device. Study prescriptions refer to sets of instructions, conditions, protocols, and/or the like, that specify one or more of an information gathering scheme and a communication scheme, and may be configured, for example, to obtain information at a resolution sufficient for performing a certain analysis (e.g., associated with a diagnostic model), while managing the resulting impact to device longevity and/or performance.

Abstract: Electrical energy delivery tissue site validation systems and methods can determine an indication of a tissue type at a tissue site. This information can be used to enable or inhibit electrical energy delivery to the tissue site. The tissue type at the tissue site can be determined such as by delivering a test electrical energy and sensing a responsive electrical energy. An electrical connectivity to the tissue site can also be determined, such as by using a sensed intrinsic electrical signal at the tissue site. Tissue type information may be communicated externally, such as to allow user confirmation or override of the determined indication of tissue type at the tissue site, such as by a physician, user, or other operator.

Abstract: An example of a method embodiment may include receiving a user programmable neural stimulation (NS) dose for an intermittent neural stimulation (INS) therapy, and delivering the INS therapy with the user programmable NS dose to an autonomic neural target of a patient. Delivering the INS therapy may include delivering NS bursts, and delivering the NS bursts may include delivering a number of NS pulses per cardiac cycle during a portion of the cardiac cycles and not delivering NS pulses during a remaining portion of the cardiac cycles. The method may further include sensing cardiac events within the cardiac cycles, and controlling delivery of the user programmable NS dose of INS therapy using the sensed cardiac events to time delivery of the number of NS pulses per cardiac cycle to provide the user programmable NS dose. The user programmable NS dose may determine the number of NS pulses per cardiac cycle.

Abstract: Disclosed herein, among other things, are methods and apparatus related to apnea therapy. One aspect of the present subject matter provides a method for apnea directed therapy. The method includes receiving a signal indicative of a real-time determination of type of an apnea event for a patient during the apnea event, and using the signal to select appropriate therapy to be applied to the patient during the apnea event to treat the apnea event, and to withhold inappropriate therapy. The therapy is applied in a closed loop system, in various embodiments. In various embodiments, the signal includes a determination of whether the apnea event is primarily an obstructive sleep apnea (OSA) event or primarily a central sleep apnea (CSA) event.

Abstract: Some embodiments provide a method, comprising performing a neural stimulation test routine for stimulating a neural target in a cervical region of a patient, wherein for each of a plurality of head positions, performing the neural stimulation test routine includes testing a plurality of electrode configurations. The method further comprises recording threshold data for each of the tested electrode configurations for the plurality of head positions, and recommending an electrode configuration based on the recorded threshold data.

Abstract: Various implantable device embodiments may comprise a neural stimulator configured to deliver a neurostimulation therapy with stimulation ON times and stimulation OFF times where a dose of the neurostimulation therapy is provided by a number of neurostimulation pulses over a period of time. The neural stimulator may be configured to monitor the dose of the delivered neurostimulation therapy against dosing parameters. The neural stimulator may be configured to declare a fault if the monitored dose does not favorably compare to a desired dose for the neurostimulation therapy, or may be configured to record data for the monitored dose of the delivered neurostimulation therapy, or may be configured to both record data for the monitored dose of the delivered neurostimulation therapy and declare a fault if the monitored dose does not favorably compare to a desired dose for the neurostimulation therapy.

Abstract: A method of optimizing the electrical stimulation of a bladder of a patient including selecting a first subset of electrodes from a set of electrodes positioned adjacent to a set of nerves associated with the bladder. The set of electrodes may include one or more electrodes, each of which may be configured to deliver electrical stimulation pulses generated by a stimulator device to the nerves. The method may further include delivering an electrical stimulation pulse through the selected first subset of electrodes and recording at least one parameter of the electrical stimulation pulse after receiving patient feedback.

Abstract: System and methods for programming and delivering electrical stimulation to treat hypertension are described. In various embodiments, an ambulatory stimulator system, such as an implantable medical device, can detect a respiration-mediated heart rate variation (RM-HRV), monitor the efficacy of hypertension therapy and adjust the stimulation parameters using the detected RM-HRV to achieve desired therapy outcome. In some embodiments, the system can be configured to synchronize the detected heart rates to one or more respiration cycles or respiration phases within the respiration cycles, and determine the RM-HRV using the heart rates synchronized with the respiration cycles or the respiration phases. The RM-HRV may be presented to the system operator to monitor the efficacy of the AHT therapy. The ambulatory stimulator system can adjust the stimulation parameters using at least the RM-HRV.

Abstract: An example of a method embodiment may include receiving a user programmable neural stimulation (NS) dose for an intermittent neural stimulation (INS) therapy, and delivering the INS therapy with the user programmable NS dose to an autonomic neural target of a patient. Delivering the INS therapy may include delivering NS bursts, and delivering the NS bursts may include delivering a number of NS pulses per cardiac cycle during a portion of the cardiac cycles and not delivering NS pulses during a remaining portion of the cardiac cycles. The method may further include sensing cardiac events within the cardiac cycles, and controlling delivery of the user programmable NS dose of INS therapy using the sensed cardiac events to time delivery of the number of NS pulses per cardiac cycle to provide the user programmable NS dose. The user programmable NS dose may determine the number of NS pulses per cardiac cycle.

Abstract: An apparatus comprises a stimulus circuit, a switch circuit, and a control circuit. The stimulus circuit is configured to provide electrical pulse stimulation to the plurality of electrodes. The switch circuit is configured to electrically couple different combinations of the electrodes to the stimulus circuit. The control circuit is to configure a stimulation vector that includes a first vector electrode and a plurality of other electrodes electrically coupled together to form a second combined vector electrode. The control circuit includes a capture detection sub-circuit configured to determine individual capture stimulation thresholds between the first vector electrode and each single electrode of the combined vector electrode. The control circuit is configured to determine a capture stimulation threshold of the stimulation vector using the determined individual capture thresholds.

Abstract: A method of optimizing the electrical stimulation of a bladder of a patient including selecting a first subset of electrodes from a set of electrodes positioned adjacent to a set of nerves associated with the bladder. The set of electrodes may include one or more electrodes, each of which may be configured to deliver electrical stimulation pulses generated by a stimulator device to the nerves. The method may further include delivering an electrical stimulation pulse through the selected first subset of electrodes and recording at least one parameter of the electrical stimulation pulse after receiving patient feedback.

Abstract: A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy.