Abstract: Battery management circuitry for an implantable medical device such as an implantable neurostimulator is described. The circuitry has a T-shape with respect to the battery terminal, with charging circuitry coupled between rectifier circuitry and the battery terminal on one side of the T, and load isolation circuitry coupled between the load and the battery terminal on the other side. The load isolation circuitry can comprise two switches wired in parallel. An undervoltage fault condition opens both switches to isolate the battery terminal from the load to prevent further dissipation of the battery. Other fault conditions will open only one the switches leaving the other closed to allow for reduced power to the load to continue implant operations albeit at safer low-power levels. The battery management circuitry can be fixed in a particular location on an integrated circuit which also includes for example the stimulation circuitry for the electrodes.

Abstract: Circuitry for generating a compliance voltage (V+) for the current sources and/or sinks in an implantable stimulator device in disclosed. The circuitry assesses whether V+ is optimal for a given pulse, and if not, adjusts V+ for the next pulse. The circuitry uses amplifiers to measure the voltage drop across active PDACs (current sources) and NDAC (current sinks) at an appropriate time during the pulse. The measured voltages are assessed to determine whether they are high or low relative to optimal values. If low, a V+ regulator is controlled to increase V+ for the next pulse; if not, the V+ regulator is controlled to decrease V+ for the next pulse. Through this approach, gradual changes that may be occurring in the implant environment can be accounted for, with V+ adjusted on a pulse-by-pulse basis to keep the voltage drops at or near optimal levels for efficient DAC operation.

Abstract: The disclosed techniques allow for externalizing errors from an implantable medical device using the device's charging coil, for receipt at an external charger or other external device. Transmission of errors in this manner is particularly useful when telemetry of error codes through a traditional telemetry coil in the implant is not possible, for example, because the error experienced is so fundamental as to preclude use of such traditional means. By externalizing the error via the charging coil, and though the use of robust error modulation circuitry in the implant designed to be generally insensitive to fundamental errors, the external charger can be consulted to understand the failure mode involved, and to take appropriate action.

Abstract: A closed loop system is disclosed for monitoring patient movements, such as tremors, and for automatically controlling an implantable stimulator device on the basis of the detected movements. The system includes a motion sensor such as a wearable item that contains an accelerometer to monitor a patient's movements, such as a ring locatable proximate to a patient's hand tremor. The motion sensor periodically transmits a feedback signal to the implantable stimulator device instructing it to change the stimulation parameters, such as current amplitude, in an attempt to reduce the tremor. The motion sensor can additionally communicate with other system components such as an external controller. In a preferred embodiment, the motion sensor and the implantable stimulator device communicate using short range electromagnetic radio waves.

Abstract: Improved circuitry for an Implantable Pulse Generator (IPG) is disclosed that allows much smaller-value DC-blocking capacitors to be used with supported electrodes—with capacitance values orders of magnitude smaller than those used in traditional IPGs. Such improved circuitry operates by alternating the direction of the current through the DC-blocking capacitor during the provision of a therapeutic current pulse. Such smaller-value DC-blocking capacitors do not take up significant space in the IPG, or surface area on the IPG's PCB. Additionally, the improved circuitry includes the ability to measure the current amplitude provided to selected electrodes—for example, to ensure that the sources are actually providing a prescribed current amplitude to the patient's tissue—and to provide for perfect active charge recovery.

Abstract: Improved circuitry for an Implantable Pulse Generator (IPG) is disclosed that allows much smaller-value DC-blocking capacitors to be used with supported electrodes—with capacitance values orders of magnitude smaller than those used in traditional IPGs. Such improved circuitry operates by alternating the direction of the current through the DC-blocking capacitor during the provision of a therapeutic current pulse. Such smaller-value DC-blocking capacitors do not take up significant space in the IPG, or surface area on the IPG's PCB. Additionally, the improved circuitry includes the ability to measure the current amplitude provided to selected electrodes—for example, to ensure that the sources are actually providing a prescribed current amplitude to the patient's tissue—and to provide for perfect active charge recovery.

Abstract: A rechargeable-battery Implantable Medical Device (IMD) is disclosed including a primary battery which can be used as a back up to power critical loads in the IMD when the rechargeable battery is undervoltage and other non-critical loads are thus decoupled from the rechargeable battery. A rechargeable battery undervoltage detector provides at least one rechargeable battery undervoltage control signal to a power supply selector, which is used to set the power supply for the critical loads either to the rechargeable battery voltage when the rechargeable battery is not undervoltage, or to the primary battery voltage when the rechargeable battery is undervoltage. Circuitry for detecting the rechargeable battery undervoltage condition may be included as part of the critical loads, and so the undervoltage control signal(s) is reliably generated in a manner to additionally decouple the rechargeable battery from the load to prevent further rechargeable battery depletion.

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 a stimulation waveform representing a pattern of neurostimulation pulses. The programming control circuit may be configured to generate stimulation parameters controlling delivery of the neurostimulation pulses according to the stimulation waveform. The GUI may be configured to define the stimulation waveform as a function of one or more adjustable parameter curves each being a function of time. The one or more adjustable parameter curves each represent a user-programmable parameter. The GUI includes a waveform definition module that may be configured to present the stimulation waveform, present each parameter curve of the one or more adjustable parameter curves, allow for adjustment of the each parameter curve, and update the stimulation waveform in response to the adjustment of the each parameter curve.

Abstract: An implantable microstimulator configured to be implanted beneath a patient's skin for tissue stimulation employs a bi-directional RF telemetry link for allowing data-containing signals to be sent to and from the implantable microstimulator from at least two external devices. Further, a separate electromagnetic inductive telemetry link allows data containing signals to be sent to the implantable microstimulator from at least one of the two external devices. The RF bidirectional telemetry link allows the microstimulator to inform the patient or clinician regarding the status of the microstimulator device, including the charge level of a power source, and stimulation parameter states. The microstimulator has a cylindrical hermetically sealed case having a length no greater than about 27 mm and a diameter no greater than about 3.3 mm. A reference electrode is located on one end of the case and an active electrode is located on the other end of the case.

Abstract: Timing channel circuitry for controlling stimulation circuitry in an implantable stimulator is disclosed. The timing channel circuitry comprises a addressable memory. Data for the various phases of a desired pulse are stored in the memory using different numbers of words, including a command indicative of the number of words in the phase, a next address for the next phase stored in the memory, and a pulse width or duration of the current phase, control data for the stimulation circuitry, pulse amplitude, and electrode data. The command data is used to address through the words in the current phase via the address bus, which words are sent to a control register for the stimulation circuitry. After the duration of the pulse width for the current phase has passed, the stored next address is used to access the data for the next phase stored in the memory.

Abstract: A neurostimulation device capable of being placed between an active stimulation state and an inactive stimulation state and method of using same. The neurostimulation device comprises a plurality of electrical terminals configured for being respectively coupled to a plurality of stimulation electrodes, a first solid-state switching device coupled to a first one of the electrical terminals, a variable power source coupled to the first switching device, and a controller configured for, when the neurostimulation device is in the inactive stimulation state, prompting the variable power source to selectively output a relatively low voltage to place the first switching device into a first open state and a relatively high voltage to place the first switching device into a second open state.

Abstract: A closed loop system is disclosed for monitoring patient movements, such as tremors, and for automatically controlling an implantable stimulator device on the basis of the detected movements. The system includes a motion sensor such as a wearable item that contains an accelerometer to monitor a patient's movements, such as a ring locatable proximate to a patient's hand tremor. The motion sensor periodically transmits a feedback signal to the implantable stimulator device instructing it to change the stimulation parameters, such as current amplitude, in an attempt to reduce the tremor. The motion sensor can additionally communicate with other system components such as an external controller. In a preferred embodiment, the motion sensor and the implantable stimulator device communicate using short range electromagnetic radio waves.

Abstract: Circuitry for generating a compliance voltage (V+) for the current sources and/or sinks in an implantable stimulator device is disclosed. The improved compliance voltage generation circuitry adjusts V+ to an optimal value in real time, even during the provision of a stimulation current. The circuitry uses amplifiers to measure the voltage drop across an active PDACs (current sources) and/or NDAC (current sinks) The measured voltages are input to a V+ regulator, which compares the measured voltage drops across the DACs to optimal values, and which feeds an optimized value for V+ back to the DACs in real time to keep the voltage drop(s) at those optimal levels during the stimulation current for efficient DAC operation.

Abstract: An implantable microstimulator configured for implantation beneath a patient's skin for tissue stimulation to prevent and/or treat various disorders, uses a self-contained power source. Periodic or occasional replenishment of the power source is accomplished, for example, by inductive coupling with an external device. A bidirectional telemetry link allows the microstimulator to provide information regarding the system's status, including the power source's charge level, and stimulation parameter states. Processing circuitry automatically controls the applied stimulation pulses to match a set of programmed stimulation parameters established for a particular patient. The microstimulator preferably has a cylindrical hermetically sealed case having a length no greater than about 27 mm and a diameter no greater than about 3.3 mm. A reference electrode is located on one end of the case and an active electrode is located on the other end.

Abstract: Timing channel circuitry for controlling stimulation circuitry in an implantable stimulator is disclosed. The timing channel circuitry comprises a addressable memory. Data for the various phases of a desired pulse are stored in the memory using different numbers of words, including a command indicative of the number of words in the phase, a next address for the next phase stored in the memory, and a pulse width or duration of the current phase, control data for the stimulation circuitry, pulse amplitude, and electrode data. The command data is used to address through the words in the current phase via the address bus, which words are sent to a control register for the stimulation circuitry. After the duration of the pulse width for the current phase has passed, the stored next address is used to access the data for the next phase stored in the memory.

Abstract: A closed loop system is disclosed for monitoring patient movements, such as tremors, and for automatically controlling an implantable stimulator device on the basis of the detected movements. The system includes a motion sensor such as a wearable item that contains an accelerometer to monitor a patient's movements, such as a ring locatable proximate to a patient's hand tremor. The motion sensor periodically transmits a feedback signal to the implantable stimulator device instructing it to change the stimulation parameters, such as current amplitude, in an attempt to reduce the tremor. The motion sensor can additionally communicate with other system components such as an external controller. In a preferred embodiment, the motion sensor and the implantable stimulator device communicate using short range electromagnetic radio waves.

Abstract: A rechargeable-battery Implantable Medical Device (IMD) is disclosed including a primary battery which can be used as a back up to power critical loads in the IMD when the rechargeable battery is undervoltage and other non-critical loads are thus decoupled from the rechargeable battery. A rechargeable battery undervoltage detector provides at least one rechargeable battery undervoltage control signal to a power supply selector, which is used to set the power supply for the critical loads either to the rechargeable battery voltage when the rechargeable battery is not undervoltage, or to the primary battery voltage when the rechargeable battery is undervoltage. Circuitry for detecting the rechargeable battery undervoltage condition may be included as part of the critical loads, and so the undervoltage control signal(s) is reliably generated in a manner to additionally decouple the rechargeable battery from the load to prevent further rechargeable battery depletion.

Abstract: Temperature sensing circuitry for an Implantable Medical Device (IMD) is disclosed that can be integrated into integrated circuitry in the IMD and draws very little power, thus enabling continuous temperature monitoring without undue battery depletion. Temperature sensor and threshold setting circuitry produces analog voltage signals indicative of a sensed temperature and at least one temperature threshold. Such circuitry employs a Ptat current reference stage and additional stages, which stages contains resistances that are set based on the desired temperature threshold(s) and to set the voltage range of the sensed temperature. These analog voltages are received at temperature threshold detection circuitry, which produces digital signal(s) indicating whether the sensed temperature has passed the temperature threshold(s). The digital signal(s) are then provided to digital circuitry in the IMD, where they can be stored as a function of time for later review, or used to immediately to control IMD operation.

Abstract: Charging circuitry is disclosed for receiving a magnetic charging field and using the received field to charge a battery in an Implantable Medical Device (IMD) without passive trickle charging, and even if the battery voltage (Vbat) is severely depleted. The charging circuitry includes a source capable of producing a constant charging current via a current mirror that receives a reference current for setting the charging current. Two reference current generators are provided: a first enabled when Vbat is severely depleted to produce a small non-adjustable reference current; and a second enabled once Vbat is recovered to produce a reference current that can be controlled to adjust the charging current. Because Vbat may be too low, the first generator is powered by a DC voltage produced from the magnetic charging field. A passively-generated undervoltage control signal is used to transition between use of the first and second generators.

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.