Abstract: Various embodiments concern an implantable paddle lead. The paddle can be attached to a distal portion of an elongate lead body. The paddle can comprise a main panel and a ridge that peripherally surrounds the main panel. The main panel can comprise a first face and a second face opposite the first face. One or more electrodes can be exposed on the first face but not exposed on the second face. The paddles can be sutured to anatomical structures. The sutures can be threaded through the main panel but not through the ridge. The paddle can be thicker along the ridge than along the main panel.

Abstract: An example of a method embodiment may place a set of stimulation electrodes on tissue containing the baroreceptor region, and may test bipolar configurations of the electrodes. Each of the bipolar configurations of the electrodes includes at least one of the electrodes configured to function as an anode and at least one other of the electrodes configured to function as a cathode. Testing the bipolar configurations may include stimulating the tissue using each of the bipolar configurations. For each of the tested bipolar configurations at least one physiological parameter may be monitored for a baroreflex response to stimulation of the tissue, and the baroreflex response may be recorded for each of the tested bipolar configurations.

Abstract: A system for mapping and marking baroreceptors of a patient. The system includes a mapping device, a marker, and a stimulator. The mapping device includes a plurality of electrodes to be situated on the patient. The marker is to be attached to the patient and mark a location of at least one of the plurality of electrodes based on an analysis of patient physiological responses to stimulation of the plurality of electrodes. The stimulator is to divide the plurality of electrodes into a first electrode zone and a second electrode zone and stimulate electrodes in the first electrode zone and the second electrode zone to obtain first patient physiological responses, where one of the first electrode zone and the second electrode zone is selected based on the first patient physiological responses.

Abstract: A system including a mapping device, a stimulator, and a marker. The mapping device includes a plurality of electrodes to be situated on a baroreceptor region of a patient to map baroreceptors in the baroreceptor region. The stimulator is to stimulate selected electrodes of the plurality of electrodes to obtain physiological responses from the patient in response to stimulation of the selected electrodes. The marker is to be attached to the patient to mark a location of at least one of the selected electrodes based on an analysis of the physiological responses from the patient, where the marker is to maintain its location on the patient as the mapping device is removed from the patient.

Abstract: An endoprosthesis includes a stent having an inner surface defining a lumen and an outer surface; and a polymeric cover on the outer surface of the stent. The polymeric cover includes a base and adhesion elements. When the endoprosthesis is expanded to the expanded state in a lumen defined by a vessel wall, the adhesion elements create an interlock between the vessel wall and the endoprosthesis.

Abstract: A medical apparatus comprising an implantable lead and a stylet configured for stimulation of a target region of a patient's nervous system is described. The lead includes a generally tubular lead body, a conductor, and an electrode assembly. The generally tubular lead body has a stylet lumen and a conductor lumen extending through the proximal and distal ends of the lead body. The conductor is enclosed within the conductor lumen. The electrode assembly extends from the distal end of the lead body. The electrode assembly includes a flexible polymeric carrier and an electrode on the carrier and electrically coupled to the conductor. The stylet is sized and shaped to be receivable within the stylet lumen and configured to stiffen and support the lead body. The distal portion of the stylet includes a bend having a predetermined angle of incidence relative to the proximal portion of the stylet.

Abstract: System and methods for programming and delivering electrical stimulation to treat hypertension are discussed. In various embodiments, an ambulatory stimulator system, such as an implantable medical device, can receive a power-saving command and deliver the electrical stimulation to a target site in a patient according to one or more simulation parameters including a therapy on-off pattern. In some embodiments, stimulation with therapy on-off pattern can reduce the power consumption while maintaining the anti-hypertension therapy efficacy. In some embodiments, the ambulatory stimulator system can include one or more of a physiologic response detector, a patient status detector, or a battery longevity detector. The power-saving command can be generated using one or more of the detected physiologic signal, the patient status, or the information about the battery longevity.

Abstract: An example of a system may include at least one electrode for placement on tissue in a carotid sinus region and a stimulator. The stimulator may be configured to use the at least one electrode to deliver neural stimulation to a baroreceptor region or at least one nerve innervating the baroreceptor region in the carotid sinus region to elicit a baroreflex response, and to deliver a blocking stimulation to a carotid body or at least one nerve innervating the carotid body in the carotid sinus region to inhibit a chemoreceptor response, the stimulator configured to simultaneously deliver the neural stimulation and the blocking stimulation.

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: The present disclosure presents methods and apparatuses for mapping a target physiological region, for example, during baroreceptor stimulation therapy. In an aspect, such an example apparatus of the present disclosure may include a surgical instrument configured to be securely coupled to a patient and to allow access to a target physiological region. Furthermore, the example apparatus may include an attachment element coupled to the surgical instrument and configured to releasably engage a lead, stabilize the lead during mapping of the target physiological region, and allow the lead to be repositioned relative to the target physiological region.

Abstract: An apparatus comprises a physiologic sensing circuit and a control circuit. The physiologic sensing circuit is configured to sense an electrical respiration signal representative of respiration of a subject. The control circuit includes a respiration monitor circuit and a therapy circuit. The respiration monitor circuit is configured to extract a respiration parameter from the respiration signal and detect that a value of the respiration parameter is outside of a target value range for the respiration parameter. The therapy circuit is configured to deliver neural stimulation to the carotid sinus of the subject to stimulate respiration and to adjust respiration to maintain the value of the respiration parameter within the target value range.

Abstract: A cardiac pacing system introduces a transitional period when pacing mode changes, such as when pacing starts and stops, or when one or more pacing parameter values change substantially. For each pacing parameter that changes substantially when the pacing mode changes, its value is adjusted incrementally over the transitional period to protect the heart from potentially harmful conditions associated with an abrupt change in the value of that pacing parameter.

Abstract: System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In various embodiments, the system includes an adhesion patch and at least one electrode. The adhesion patch includes a passive adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site.

Abstract: A guide catheter system includes a guide catheter having a proximal end, a distal end, an outer wall and a first, second and third electrode wherein the first, second and third electrodes are spaced longitudinally apart from each other on the outer wall of the catheter, and an electrical impulse generator connected to the guide catheter wherein the electrical impulse generator includes a circuit for selecting an adjacent pair of electrodes to use as a bipolar electrode system to send an electrical impulse and a method of use thereof to treat vasospasm.

Abstract: System and methods for adhering a patch of stimulation electrode(s) to blood vessels to stimulate a target site on the blood vessel are described. In one embodiment, the system includes an adhesion patch and at least one electrode. The adhesion patch includes an active adhesion mechanism that may produce an adhesive force sufficiently strong to adhere the adhesion patch to the exterior of the blood vessel and to operationally position the at least one electrode for use in electrically stimulating a target site of the blood vessel. The adhesion patch may also include a release mechanism that is configured for a user to disengage the patch from the exterior of the blood vessel without significant trauma to the blood vessel. After being released, the adhesion patch may be re-adhered to a different target site of the blood vessel and stimulate the different target site.

Abstract: Various neural stimulator embodiments comprise controller circuitry, neural stimulation output circuitry, sensor circuitry and a memory. The neural stimulation output circuitry is configured to deliver the neural stimulation. The controller circuitry is configured to control stimulation parameters of the neural stimulation delivered by the neural stimulation output circuitry. The sensor circuitry, including at least one sensor, is configured to sense a response to the neural stimulation. The controller is configured to communicate with the sensor circuitry. The memory has instructions stored therein, operable on by the controller circuitry.

Abstract: An electrode structure for an implantable stimulation lead for use in stimulating a target nerve structure within a patient includes a flexible backing defined by a major dimension extending in a direction of a first axis, and a minor dimension extending generally orthogonal to the first axis. The electrode structure also includes a plurality of electrodes coupled to the backing.

Abstract: An example of a method embodiment may place a set of stimulation electrodes on tissue containing the baroreceptor region, and may test bipolar configurations of the electrodes. Each of the bipolar configurations of the electrodes includes at least one of the electrodes configured to function as an anode and at least one other of the electrodes configured to function as a cathode. Testing the bipolar configurations may include stimulating the tissue using each of the bipolar configurations. For each of the tested bipolar configurations at least one physiological parameter may be monitored for a baroreflex response to stimulation of the tissue, and the baroreflex response may be recorded for each of the tested bipolar configurations.

Abstract: A guide catheter system includes a guide catheter having a proximal end, a distal end, an outer wall and a first, second and third electrode wherein the first, second and third electrodes are spaced longitudinally apart from each other on the outer wall of the catheter, and an electrical impulse generator connected to the guide catheter wherein the electrical impulse generator includes a circuit for selecting an adjacent pair of electrodes to use as a bipolar electrode system to send an electrical impulse and a method of use thereof to treat vasospasm.

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.