Abstract: A system may be configured to sense local field potentials (LFPs) from electrodes placed in epidural space near the spine of a patient. The system may be configured to analyze the sensed LFPs and determine a change in a state of the patient, such as a physiological state of the patient. The system may use such analysis to update and/or suggest parameters for delivery of electrical stimulation therapy. The system may further be configured to analyze LFPs in a frequency domain by applying a wavelet transform or other transform to sensed LFPs.

Abstract: An example medical device includes processing circuitry configured to determine an electrode impedance value for each of one or more electrodes of a lead coupled to the medical device, identify one or more of the electrodes having electrode impedance values that are greater than electrode impedance values of other electrodes of the lead, from the identified one or more electrodes, determine a recommendation of electrodes to use for sensing a signal, and output information indicative of the recommendation.

Abstract: Examples of implantable medical leads or implantable medical systems with implantable medical leads to be anchored to a sacrum are disclosed. The implantable medical leads include a lead body having a distal portion. A fixation mechanism is coupled to the distal portion. An electrode array is mechanically coupled to the fixation mechanism. In one example, the electrode array is directly coupled to the fixation mechanism. The electrode array is electrically coupled to the lead body and configured to generate a stimulation field. The fixation mechanism is configured to anchor the implantable medical lead to a sacrum and effect the stimulation field in a foramen of the sacrum.

Abstract: A system for selecting a sensitivity level for adjusting an intensity setting for therapy provided to a patient includes one or more processors and one or more processors coupled to the memory. The one or more processors are configured to receive an indication of an input to adjust an intensity setting related to the therapy provided to the patient and determine a sensitivity level for adjustment of the intensity setting based on an efficacy of the therapy provided to the patient. The one or more processors are further configured to determine an updated intensity level for the intensity setting based on the sensitivity level and the input to adjust the intensity setting and output an instruction to cause a medical device to provide the therapy at the updated intensity level.

Abstract: Systems and methods for controlling and optimizing closed-loop neuromodulation therapies are provided. The system may include a pulse generator configured to generate an electrical signal that may be transmitted to a plurality of a electrodes. The plurality of electrodes may include at least one stimulating electrode and at least one recording electrode. The at least one stimulating electrode may be configured to stimulate an anatomical element based on the electrical signal and the at least one recording electrode configured to record a physiological response.

Abstract: This disclosure is directed to devices, systems, and techniques for delivering various stimulation patterns. In some examples, a method includes generating, by stimulation generation circuitry, a first train of electrical stimulation pulses at a first frequency to a first target tissue, and generating, by the stimulation generation circuitry, a second train of electrical stimulation pulses at a second frequency to a second target tissue different from the first target tissue, wherein at least some electrical stimulation pulses of the first train of electrical stimulation pulses are interleaved with at least some electrical stimulation pulses of the second train of electrical stimulation pulses, and wherein the first frequency is greater than the second frequency.

Abstract: Processing circuitry of a system configured to determine a patient state based on sensed signals including posture and activity information and control delivery of electrical stimulation therapy to the patient via electrodes implanted proximal to target tissue of the patient. The sensed signals also include impedance measurement, and other bioelectrical signals, where sensing is interleaved with the electrical stimulation therapy. Responsive to determining the patient state, select an action, wherein the selected action comprises one or more of: store collected information, upload the collected information to an external computing device, and output an electronic signal comprising an alert.

Abstract: Processing circuitry for a medical system configured to sense bioelectrical signals and determine posture and activity information as well as information about the environment of the patient. The processing circuitry is also configured to control stimulation generation circuitry to deliver the electrical stimulation therapy, and interleaved with the electrical stimulation therapy, control the stimulation generation circuitry to output an impedance measurement signal. The processing circuitry is further configured to determine respiration of the patient based on the impedance. Responsive to determining the respiration of the patient, the processing circuitry may then determine a patient state based on the determined respiration, and the posture and activity information of the patient.

Abstract: Processing circuitry for a medical system configured to determine posture and activity information of a patient and sense bioelectrical signals as well as receive information about the environment of the patient. The processing circuitry is configured to determine respiration activity of the patient based on the sensed signals and determine a degree of distress of the patient based on the sensed signals and the determined respiration activity. Responsive to determining the degree of distress, the processing circuitry is configured to output a command signal, which may adjust the output of stimulation circuitry configured to deliver electrical stimulation to a patient via a set of electrodes implanted proximal target tissue of the patient, upload the received information, cause the communication circuitry to send an electronic message comprising a notification of the degree of distress of the patient or take other actions.

Abstract: A system includes telemetry circuitry configured for communication between a medical device and an external device associated with the medical device and processing circuitry. The processing circuitry is configured to receive an indication of a plurality of user inputs, each user input of the plurality of user inputs indicating a respective value of a plurality of values for a stimulation parameter that at least partially defines therapy provided to the patient in a posture state of a plurality of posture states. The processing circuitry is further configured to determine a representative value for the stimulation parameter based on the plurality of values for the stimulation parameter that at least partially defines therapy provided to the patient in the posture state. The processing circuitry is further configured to control the medical device to provide the therapy according to the representative value.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for pacing a HIS bundle of a patient. The apparatuses, systems, and methods may include applying stimulation energy through one or more of a plurality of electrodes to direct a stimulation locus and pace a HIS bundle of a patient.

Abstract: A system for prioritizing patient information associated with one or more patients of a plurality of patients receiving treatment via respective devices of a plurality of medical devices, the system comprising memory and one or more processors coupled to the memory. The one or more processors are configured to receive patient information from each medical device of the plurality of medical devices and select the patient information from a subset of the plurality of medical devices based on one or more importance attributes associated with the patient information. The one or more processors are further configured to prioritize the selected patient information to generate a list of one or more prioritized patients of the plurality of patients and cause an output of an indication of the patient information for the one or more prioritized patients.

Abstract: A system for selecting a sensitivity level for adjusting an intensity setting for therapy provided to a patient includes one or more processors and one or more processors coupled to the memory. The one or more processors are configured to receive an indication of an input to adjust an intensity setting related to the therapy provided to the patient and determine a sensitivity level for adjustment of the intensity setting based on an efficacy of the therapy provided to the patient. The one or more processors are further configured to determine an updated intensity level for the intensity setting based on the sensitivity level and the input to adjust the intensity setting and output an instruction to cause a medical device to provide the therapy at the updated intensity level.

Abstract: A device comprising memory and processing circuitry coupled to the memory. The processing circuitry is configured to receive patient information for a medical device associated with the patient and select a communication mode for the patient based on the patient information. The processing circuitry is further configured to cause an output of the indication of the patient information using the selected communication mode.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for pacing a HIS bundle of a patient. The apparatuses, systems, and methods may include applying stimulation energy through one or more of a plurality of electrodes to direct a stimulation locus and pace a HIS bundle of a patient.

Abstract: An implantable medical lead for sacral modulation therapy is disclosed. The implantable medical lead includes a lead body having a distal portion. An electrode is electrically coupled to the lead body and configured to generate a stimulation field or to sense electrical fields. A fixation mechanism is coupled to the distal portion. The fixation mechanism is configured to anchor the implantable medical lead against an interior wall of a blood vessel. The electrode can effect the stimulation field from within the vessel to stimulate a selected sacral nerve or sense electrical signals such as muscle or nerve responses. Guided implantation of the medical lead or other medical leads through the body to a nerve of interest for neurostimulation via remote sensor is also disclosed.

Abstract: A system may receive first information relating to a patient captured during a baseline period that is prior to the patient receiving stimulation. The system may receive second information relating to the patient captured during an initial therapy assignment. The second information may include testing data generated by delivering stimulation during an implant procedure. The system may determine initial stimulation program settings based on the first information, the second information and population-informed information. The population-informed information may be related to other patients. The system may cause, during a training period, delivery of therapy based on the initial stimulation program settings.

Abstract: Examples of implantable medical leads or implantable medical systems with implantable medical leads to be anchored to a sacrum are disclosed. The implantable medical leads include a lead body having a distal portion. A fixation mechanism is coupled to the distal portion. An electrode array is mechanically coupled to the fixation mechanism. In one example, the electrode array is directly coupled to the fixation mechanism. The electrode array is electrically coupled to the lead body and configured to generate a stimulation field. The fixation mechanism is configured to anchor the implantable medical lead to a sacrum and effect the stimulation field in a foramen of the sacrum.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for pacing a HIS bundle of a patient. The apparatuses, systems, and methods may include applying stimulation energy through one or more of a plurality of electrodes to direct a stimulation locus and pace a HIS bundle of a patient.