Abstract: The problem of a potentially high amount of supra-threshold charge passing through the patient's tissue at the end of an Implantable Pulse Generator (IPG) program is addressed by circuitry that periodically dissipates only small amount of the charge stored on capacitances (e.g., DC-blocking capacitors) during a pulsed post-program recovery period. This occurs by periodically activating control signals to turn on passive recovery switches to form a series of discharge pulses each dissipating a sub-threshold amount of charge. Such periodic pulsed dissipation may extend the duration of post-program recovery, but is not likely to be noticeable by the patient when the programming in the IPG changes from a first to a second program. Periodic pulsed dissipation of charge may also be used during a program, such as between stimulation pulses.

Abstract: Electrode voltage monitoring circuitry for an implantable neurostimulator system having a plurality of electrode-driver integrated circuits (ICs) in provided. Electrodes from either or both ICs can be chosen to provide stimulation, and one of the IC acts as the master while the other acts as the slave. Electrodes voltages on the slave IC are routed to the master IC, and thus the master IC can monitor both electrode voltages on the slave as well as electrode voltages on the master. Such voltages can be monitored for a variety of purposes, and in particular use of such voltage is disclosed for determining the resistance between electrodes and to set a compliance voltage for stimulation.

Abstract: A current generation architecture for an implantable stimulator device such as an Implantable Pulse Generator (IPG) is disclosed. Current source and sink circuitry are both divided into coarse and fine portions, which respectively can provide coarse and fine current resolutions to a specified electrode on the IPG. The coarse portion is distributed across all of the electrodes and so can source or sink current to any of the electrodes. The coarse portion is divided into a plurality of stages, each of which is capable via an associated switch bank of sourcing or sinking a coarse amount of current to or from any one of the electrodes on the device. The fine portion of the current generation circuit preferably includes source and sink circuitry dedicated to each of the electrode on the device, which can comprise digital-to-analog current converters (DACs).

Abstract: Multi-phasic fields are produced at a neuromodulation site using electrodes. A first phase is directed at a target region such that a first-polarity electrical charge is injected to the target region, and a second phase is directed at portions of the neuromodulation site other than the target region, such that a second-polarity electrical charge opposite the first-polarity electrical charge is injected to those portions of the neuromodulation site to essentially neutralize the first-polarity charge injected at the neuromodulation site while maintaining at least a portion of the first-polarity charge at the target region. In some embodiments, each anode used to produce the first phase is used as a cathode to produce the second phase, and each cathode used to produce the first phase is used as an anode to produce the second phase, and the quantity of charge injected by each electrode in both phases is essentially zero.

Abstract: A neuromodulation system configured for providing sub-threshold neuromodulation therapy to a patient. The neuromodulation system comprises a neuromodulation lead having at least one electrode configured for being implanted along a spinal cord of a patient, a plurality of electrical terminals configured for being respectively coupled to the at least one electrode, modulation output circuitry configured for delivering sub-threshold modulation energy to active ones of the at least one electrode, and control/processing circuitry configured for selecting a percentage from a plurality of percentages based on a known longitudinal location of the neuromodulation lead relative to the spinal cord, computing an amplitude value as a function of the selected percentage, and controlling the modulation output circuitry to deliver sub-threshold modulation energy to the patient at the computed amplitude value.

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: Compliance voltage generation circuitry for a medical device is disclosed. The circuitry in one embodiment comprises a boost converter and a charge pump, either of which is capable of generating an appropriate compliance voltage from the voltage of the battery in the device. A boost signal from compliance voltage monitor-and-adjust logic circuitry is processed with a telemetry enable signal to selectively enable either the charge pump or the boost converter: if the telemetry enable signal is not active, the boost converter is used to generate the compliance voltage; if the telemetry enable signal is active, the charge pump is used. Because the charge pump circuitry does not produce a magnetic field, the charge pump will not interfere with magnetically-coupled telemetry between the implant and an external controller. By contrast, the boost converter is allowed to operate during periods of no telemetry, when magnetic interference is not a concern.

Abstract: An implantable medical device system includes an implantable medical device for providing stimulation therapy and two external power sources. A first external power source is used to power the implantable medical device when the stimulation therapy is low energy therapy. For example, the first external power device may be utilized to periodically recharge a battery in the implantable medical device. The second external power device may be utilized to power the implantable medical device when the stimulation therapy is high energy therapy. The second external power device may be a disposable patch that is affixed to a patient's skin to provide continuous power to the implantable medical device. The implantable medical device may communicate data to such a power device to cause it to adjust a strength of the charging field that it generates.

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: Recovery circuitry for passively recovering charge from capacitances at electrodes in an Implantable Pulse Generator (IPG) is disclosed. The passive recovery circuitry includes passive recovery switches intervening between each electrode node and a common reference voltage, and each switch is in series with a variable resistance that may be selected based on differing use models of the IPG. The passive recovery switches may also be controlled in different modes. For example, in a first mode, the only recovery switches closed after a stimulation pulse are those associated with electrodes used to provide stimulation. In a second mode, all recovery switches are closed after a stimulation pulse, regardless of the electrodes used to provide stimulation. In a third mode, all recovery switches are closed continuously, which can provide protection when the IPG is in certain environments (e.g., MRI), and which can also be used during stimulation therapy itself.

Abstract: This document discusses, among other things, systems and methods to provide a paresthesia therapy to a patient using an implantable neuromodulation system, wherein providing the paresthesia therapy may include delivering to the patient an electrical waveform having a duration and a distribution of frequencies in the range of 0.001 kHz to 20 kHz, wherein the distribution of frequencies includes a first frequency group of one or more frequencies and a second frequency group of one or more frequencies, and wherein the patient continuously experiences paresthesia throughout the duration of the electrical waveform.

Abstract: An algorithm programmed into the control circuitry of a rechargeable-battery Implantable Medical Device (IMD) is disclosed that can quantitatively forecast and determine the timing of an early replacement indicator (tEOLi) and an IMD End of Life (tEOL). These forecasts and determinations of tEOLi and tEOL occur in accordance with one or more 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, determines and forecasts tEOLi and tEOL. Such forecasted or determined values may also be used by a shutdown algorithm to suspend therapeutic operation of the IMD.

Abstract: An example of a system may include an electrode arrangement, a neural modulation generator configured to use electrodes in the electrode arrangement to generate a modulation field, a communication module configured to receive commands, a memory configured to store modulation field parameter data, and a controller configured to control the neural modulation generator to generate the modulation field. The controller may be configured to implement a trolling routine to troll the modulation field through neural tissue positions, and implement a marking routine multiple times as the modulation field is trolled through the neural tissue positions to identify when the modulation field provides patient-perceived modulation.

Abstract: Compliance voltage generation circuitry for a medical device is disclosed. The circuitry in one embodiment comprises a boost converter and a charge pump, either of which is capable of generating an appropriate compliance voltage from the voltage of the battery in the device. A boost signal from compliance voltage monitor-and-adjust logic circuitry is processed with a telemetry enable signal to selectively enable either the charge pump or the boost converter: if the telemetry enable signal is not active, the boost converter is used to generate the compliance voltage; if the telemetry enable signal is active, the charge pump is used. Because the charge pump circuitry does not produce a magnetic field, the charge pump will not interfere with magnetically-coupled telemetry between the implant and an external controller. By contrast, the boost converter is allowed to operate during periods of no telemetry, when magnetic interference is not a concern.

Abstract: An implantable medical device system includes an implantable medical device for providing stimulation therapy and two external power sources. A first external power source is used to power the implantable medical device when the stimulation therapy is low energy therapy. For example, the first external power device may be utilized to periodically recharge a battery in the implantable medical device. The second external power device may be utilized to power the implantable medical device when the stimulation therapy is high energy therapy. The second external power device may be a disposable patch that is affixed to a patient's skin to provide continuous power to the implantable medical device. The implantable medical device may communicate data to such a power device to cause it to adjust a strength of the charging field that it generates.

Abstract: An external charger for a battery in an implantable medical device and charging techniques are disclosed. Simulation data is used to model the power dissipation of the charging circuitry in the implant at varying levels of implant power. A power dissipation limit constrains the charging circuitry from producing an inordinate amount of heat to the tissue surrounding the implant, and duty cycles of a charging field are determined so as not to exceed that limit. A maximum simulated average battery current determines the optimal (i.e., quickest) battery charging current, and at least an optimal value for a parameter indicative of that current is determined and stored in the external charger. During charging, the actual value for that parameter is determined, and the intensity and/or duty cycle of the charging field are adjusted to ensure that charging is as fast as possible, while still not exceeding the power dissipation limit.

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: A method for configuring stimulation pulses in an implantable stimulator device having a plurality of electrodes is disclosed, which method is particularly useful in adjusting the electrodes by current steering during initialization of the device. In one aspect, a set of ideal pulses for patient therapy is determined, in which at least two of the ideal pulses are of the same polarity and are intended to be simultaneous applied to corresponding electrodes on the implantable stimulator device during an initial duration. These pulses are reconstructed into fractionalized pulses, each comprised of pulse portions. The fractionalized pulses are applied to the corresponding electrodes on the device during a final duration, but the pulse portions of the fractionalized pulses are not simultaneously applied during the final duration.

Abstract: A neuromodulation system configured for providing sub-threshold neuromodulation therapy to a patient. The neuromodulation system comprises a neuromodulation lead having at least one electrode configured for being implanted along a spinal cord of a patient, a plurality of electrical terminals configured for being respectively coupled to the at least one electrode, modulation output circuitry configured for delivering sub-threshold modulation energy to active ones of the at least one electrode, and control/processing circuitry configured for selecting a percentage from a plurality of percentages based on a known longitudinal location of the neuromodulation lead relative to the spinal cord, computing an amplitude value as a function of the selected percentage, and controlling the modulation output circuitry to deliver sub-threshold modulation energy to the patient at the computed amplitude value.

Abstract: Disclosed herein are circuits and methods for a multi-electrode implantable stimulator device incorporating one decoupling capacitor in the current path established via at least one cathode electrode and at least one anode electrode. In one embodiment, the decoupling capacitor may be hard-wired to a dedicated anode on the device. The cathodes are selectively activatable via stimulation switches. In another embodiment, any of the electrodes on the devices can be selectively activatable as an anode or cathode. In this embodiment, the decoupling capacitor is placed into the current path via selectable anode and cathode stimulation switches. Regardless of the implementation, the techniques allow for the benefits of capacitive decoupling without the need to associate decoupling capacitors with every electrode on the multi-electrode device, which saves space in the body of the device.