Abstract: Methods and systems for monitoring and modifying pulsed field ablation (PFA) energy delivery to prevent patient safety risks and/or delivery device failure. In particular, some embodiments provide methods and systems for detecting and preventing arcs and arc-induced plasma, and their causal events, during delivery of pulsed field ablation energy, as well as methods and systems for identifying conditions leading to potential delivery device failure and correcting charge imbalance or asymmetry.

Abstract: Methods and systems for monitoring and modifying pulsed field ablation (PFA) energy delivery to prevent patient safety risks and/or delivery device failure. In particular, some embodiments provide methods and systems for detecting and preventing arcs and arc-induced plasma, and their causal events, during delivery of pulsed field ablation energy, as well as methods and systems for identifying conditions leading to potential delivery device failure and correcting charge imbalance or asymmetry.

Abstract: In one aspect, a programmer for an implantable medical device comprises a user interface that receives user input corresponding to one or more selected stimulation therapy parameters for delivering stimulation therapy to a patient with the implantable medical device and presents an energy consumption estimate of a power source based on the selected stimulation therapy parameters; and a processor that determines one or more programming options that, if selected, would alter the selected stimulation therapy parameters and reduce the energy consumption estimate. The user interface presents at least one of the programming options to reduce the energy consumption estimate to the user with an indication that user selection of one or more of the presented programming options would alter the selected stimulation therapy parameters to reduce energy consumption of the implantable medical device.

Abstract: This disclosure is related to techniques for presenting therapy factors related to medical device therapy in a manner that allows a user, such as a patient or a clinician, to receive, comprehend and evaluate information relating to therapy delivered by the medical device efficiently. In one aspect, a method comprises obtaining a data set corresponding to a therapy factor associated with delivery of a medical therapy to a patient with a medical system including an implantable medical device, receiving a user selection associated with a subset of the data set, the subset of the data set including less than all the information relating to the therapy factor in the data set, and presenting a representation, corresponding to the subset of the data set, of the therapy factor on a display of a programmer.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: One or more efficacious electrode combinations for delivering electrical stimulation therapy to a patient may be selected based on the delivery of electrical stimulation to the patient via a predefined set of test electrode combinations in a predetermined order. In some examples, the electrode combinations of the set are arranged in the predetermined order such that adjacent electrode combinations in the order include at least one shared anode electrode or cathode electrode. In addition, the electrode combinations in the predetermined order may define a predetermined sequence of electrode patterns, each electrode pattern defining a relative arrangement between one or more anodes and one or more cathodes of the respective electrode pattern. In some examples, the transition between electrode combinations in the predefined set is achieved by incrementally adjusting at least one of anodic amplitudes assigned to active anode electrodes or cathodic amplitudes assigned to active cathode electrodes.

Abstract: This disclosure is related to techniques for presenting therapy factors related to medical device therapy in a manner that allows a user, such as a patient or a clinician, to receive, comprehend and evaluate information relating to therapy delivered by the medical device efficiently. In one aspect, a method comprises obtaining a data set corresponding to a therapy factor associated with delivery of a medical therapy to a patient with a medical system including an implantable medical device, receiving a user selection associated with a subset of the data set, the subset of the data set including less than all the information relating to the therapy factor in the data set, and presenting a representation, corresponding to the subset of the data set, of the therapy factor on a display of a programmer.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: One or more efficacious electrode combinations for delivering electrical stimulation therapy to a patient may be selected based on the delivery of electrical stimulation to the patient via a predefined set of test electrode combinations in a predetermined order. In some examples, the electrode combinations of the set are arranged in the predetermined order such that adjacent electrode combinations in the order include at least one shared anode electrode or cathode electrode. In addition, the electrode combinations in the predetermined order may define a predetermined sequence of electrode patterns, each electrode pattern defining a relative arrangement between one or more anodes and one or more cathodes of the respective electrode pattern. In some examples, the transition between electrode combinations in the predefined set is achieved by incrementally adjusting at least one of anodic amplitudes assigned to active anode electrodes or cathodic amplitudes assigned to active cathode electrodes.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: This disclosure describes techniques for obtaining an image of an anatomical implant region where leads associated with an implantable medical device are implanted in a patient, manipulating the image to show lead locations and placements, performing necessary image compression and manipulations, adjusting the image to associate it with information (e.g., patient, metadata, annotations, etc.) useful to a subsequent programmer retrieving the image, and transferring a copy of the captured image to the implantable medical device. The image stored in the implantable medical device may be retrieved at a later time by a user of programmer, where the user can use the image and other associated information to program subsequent therapy.

Abstract: This disclosure describes techniques for combining an image of a region defined by the user to receive stimulation therapy with an image of representation of leads which will deliver the therapy to the defined region, and importing the combined image on an implantable medical device connected to the leads that will deliver the stimulation therapy. During the process of combining the images, the user manipulates one or both of the images to combine the image such that the leads are placed for accurate therapy delivery. In some examples where more than one region is to receive stimulation therapy, each region can have a different image and/or a different set of leads associated therewith, and a combined image of each region may be produced, manipulated, and imported on the implantable medical device.

Abstract: This disclosure describes techniques for programming stimulation therapy programs according to therapy targets (e.g., symptoms or areas of pain) in a patient to which they are applied. Several programs can be programmed for each therapy target, stored on an implantable medical device, and retrieved later by a programmer to modify, edit, delete, create, and/or select a therapy program for each of the therapy targets. Each therapy target is independent from the other therapy targets, and a user can select or change a program under one therapy target without affecting programs under the other therapy targets. During programming, a user can specify parameters for each program applicable to only that program, and can specify parameters for each therapy target applicable to every program associated with that therapy target. The organization of programs into slots and the selection of a program in each slot may be manual or automated.

Abstract: Assessing symptomatic and asymptomatic physiologic changes due to chronic heart failure involves apparatus and methods for gauging degradation and possible improvement using automated measurement of inter-ventricular conduction time, both alone and in combination with other automated physiologic tests. Conduction times increase due to the greater distance a wavefront must traverse as a heart enlarges. Analysis of conduction time can be used to verify the occurrence of cardiac remodeling due to heart failure as well as beneficial reverse remodeling due to successful heart failure therapy delivery. Patient activity level(s) and presence/increase in pulmonary fluids can also be used to automatically determine changes in heart failure status and/or predict hospitalization. Conduction time is monitored between electrodes positioned in the left and right ventricles of the heart via endocardial or epicardial electrodes.

Abstract: This disclosure describes techniques for programming stimulation therapy programs according to therapy targets (e.g., symptoms or areas of pain) in a patient to which they are applied. Several programs can be programmed for each therapy target, stored on an implantable medical device, and retrieved later by a programmer to modify, edit, delete, create, and/or select a therapy program for each of the therapy targets. Each therapy target is independent from the other therapy targets, and a user can select or change a program under one therapy target without affecting programs under the other therapy targets. During programming, a user can specify parameters for each program applicable to only that program, and can specify parameters for each therapy target applicable to every program associated with that therapy target. The organization of programs into slots and the selection of a program in each slot may be manual or automated.

Abstract: This disclosure is related to techniques for presenting therapy factors related to medical device therapy in a manner that allows a user, such as a patient or a clinician, to receive, comprehend and evaluate information relating to therapy delivered by the medical device efficiently. In one aspect, a method comprises obtaining a data set corresponding to a therapy factor associated with delivery of a medical therapy to a patient with a medical system including an implantable medical device, receiving a user selection associated with a subset of the data set, the subset of the data set including less than all the information relating to the therapy factor in the data set, and presenting a representation, corresponding to the subset of the data set, of the therapy factor on a display of a programmer.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: Assessing symptomatic and asymptomatic physiologic changes due to chronic heart failure involves apparatus and methods for gauging degradation and possible improvement using automated measurement of inter-ventricular conduction time, both alone and in combination with other automated physiologic tests. Conduction times increase due to the greater distance a wavefront must traverse as a heart enlarges. Analysis of conduction time can be used to verify the occurrence of cardiac remodeling due to heart failure as well as beneficial reverse remodeling due to successful heart failure therapy delivery. Patient activity level(s) and presence/increase in pulmonary fluids can also be used to automatically determine changes in heart failure status and/or predict hospitalization. Conduction time is monitored between electrodes positioned in the left and right ventricles of the heart via endocardial or epicardial electrodes.