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. Between titration sessions one or more parameters, such as, for example, an acclimation interval, may be adjusted based on the patient's response to the stimulation. This personalized titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: A system and method for providing cardiac pulmonary nerve stimulation (CPNS) with therapy titration, a goodness indicator, and therapy weaning. Therapy titration can include using physiological measurements of contractility, lusitropy, and chronotropy to determine therapy efficacy and adjust therapy delivery. For example, the electrode position and stimulation intensity can be adjusted based on the physiological measurements. Therapy titration can include closed-loop therapy delivery, in which therapy is automatically adjusted based on the measured physiological parameters. A goodness indicator can be used to monitor cardiovascular parameters such as contractility, preload, lusitropy, systolic function, and/or chronotropy. The goodness indicator can determine whether the change in these parameters from nerve stimulation is positive, and further indicate optimal stimulation. Therapy weaning can include gradually reducing stimulation while ensuring no significant reduction in therapeutic efficacy ensues.

Abstract: A method of neurostimulation titration includes titrating a neurostimulation signal from a first set of parameters toward a target set of parameters according to a titration aggressiveness profile having a titration hold point. The method further includes receiving a hold indicator indicating that the titration has reached the titration hold point. The method further includes initiating an intermediate hold of the titrating of the neurostimulation signal in response to receiving the hold indicator. The method further includes receiving an indication of a titration resumption that discontinues the intermediate hold.

Abstract: A method may include delivering stimulation to a nerve of a patient using a first set of stimulation parameters. The method may further include detecting a first heart rate change within a range between a baseline heart rate and a predefined threshold. The method may further include, subsequent to detecting the first heart rate change, detecting a second heart rate change that is outside of the range between the baseline heart rate and the predefined threshold. The method may further include delivering stimulation to the nerve of the patient using a second set of stimulation parameters based on the second heart rate change being outside of the range between the baseline heart rate and the predefined threshold.

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: 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 monitoring the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time and a control system for adjusting stimulation parameters to maintain stimulation in the neural fulcrum zone based on detected changes in the physiological response to stimulation.

Abstract: An implantable vagus nerve stimulation (VNS) system includes a sensor configured to measure ECG data for a patient, a stimulation subsystem configured to deliver VNS to the patient, and a control system configured to perform a heart rate variability analysis with the ECG data. In some aspects, performing the heart rate variability analysis includes measuring R-R intervals between successive R-waves for the ECG data measured during a stimulation period of VNS therapy and a baseline period of the VNS therapy, wherein the stimulation period comprises at least a portion of the ON period and the baseline period comprises at least a portion of the OFF period immediately preceding the ON period, and generating a plot of each R-R interval against an immediately successive R-R interval for each of the stimulation period and the baseline period configured to be displayed on a display.

Abstract: Systems and methods of managing a plurality of patients undergoing titration using a management device. The method includes receiving titration parameters for a plurality of patients undergoing titration of neurostimulation delivered via implantable neurostimulators; determining a status of a progression of the titration of the neurostimulation for each patient based on the titration parameters, the status of the progression of the titration for each patient including a current stimulation parameter for the patient; determining a priority of each patient based on the status of the progression of the titration for the patient; generating a user interface visually indicating the priority and the current stimulation parameter of each patient; receiving an update of a selected stimulation parameter for a selected patient via an input received on the user interface; and transmitting the update of the selected stimulation parameter to the implantable neurostimulator of the selected patient.

Abstract: A method of delivering neurostimulation therapy to a patient from an implantable medical device is provided. The method includes delivering, by the implantable medical device, the neurostimulation therapy to the patient. The method further includes determining, by the implantable medical device, that the patient has received a defibrillation shock from a defibrillation device. The method further includes adjusting, by the implantable medical device, the neurostimulation therapy based on determining that the patient has received the defibrillation shock.

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: 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: Systems and methods of managing a plurality of patients undergoing titration using a management device. The method includes receiving, via a processor of a management device, a plurality of patient information from the plurality of patients, evaluating, via the processor of the management device, each patient based on patient information, determining, via the processor of the management device, a status of each patient, where the status is based on a progression of the titration based on titration assist parameters and determining, via the processor of the management device, a priority of each patient based on patient status. In some embodiments the method includes sorting that patients based on user input. In some embodiments, the plurality of patient information is received via remote communication with at least one of a programming device, an implantable medical device, or a home management device.

Abstract: A programmer configured to collect data from an implantable pulse generator about ongoing neurostimulation being applied during a stimulation titration process by the implantable pulse generator while in communication with the communication circuitry; display, via a user interface, an indication relating to a timing of neurostimulation bursts applied by the implantable pulse generator while in communication with the communication circuitry based on the collected data, the indication being displayed according to a time delay that accounts for a transport delay between the implantable pulse generator and the programmer such that the indication displayed coincides with an actual application of each stimulation burst by the implantable pulse generator; and adjust at least one stimulation parameter applied during the stimulation titration process by the implantable pulse generator.

Abstract: An implantable vagus nerve stimulation (VNS) system includes a sensor configured to measure ECG data for a patient, a stimulation subsystem configured to deliver VNS to the patient, and a control system configured to perform a heart rate variability analysis with the ECG data. In some aspects, performing the heart rate variability analysis includes measuring R-R intervals between successive R-waves for the ECG data measured during a stimulation period of VNS therapy and a baseline period of the VNS therapy, wherein the stimulation period comprises at least a portion of the ON period and the baseline period comprises at least a portion of the OFF period immediately preceding the ON period, and generating a plot of each R-R interval against an immediately successive R-R interval for each of the stimulation period and the baseline period configured to be displayed on a display.

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. Between titration sessions one or more parameters, such as, for example, an acclimation interval, may be adjusted based on the patient's response to the stimulation. This personalized titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: A neurostimulation system comprises a control system configured to monitor a patient receiving neurostimulation therapy. The neurostimulation therapy has a stimulation cycle comprising a stimulation ON period, in which the patient is receiving neurostimulation, and a stimulation OFF period, in which the patient is not receiving neurostimulation. The control system is programmed to receive electrocardiogram (ECG) data from the patient receiving the neurostimulation therapy. The control system is further programmed to monitor a heart rate of the patient based on the ECG data over at least one stimulation cycle of the neurostimulation therapy. The control system is further programmed to generate an indication of signal stability to be displayed to a user based on the received ECG data.

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: Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A titration process is used to gradually increase the stimulation intensity to a desired therapeutic level. This titration process can minimize the amount of time required to complete titration so as to begin delivery of the stimulation at therapeutically desirable levels.

Abstract: Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein.