Abstract: An implantable medical device that includes a memory, stimulation circuitry configured to deliver electrical stimulation to a patient, and processing circuitry operably coupled to the memory. The processing circuitry is configured to: control the stimulation circuitry to output electrical stimulation therapy to a patient via a first electrode combination and control the stimulation circuitry to output a notification stimulation via a second electrode combination and interleaved with the electrical stimulation therapy. The notification stimulation may include an intensity above a perception level of the patient, and the second electrode combination may include an electrode disposed at an implant site of the implantable medical device.

Abstract: Apparatus and methods for managing pain uses a single composite modulation/stimulation signal with variable characteristics to achieve the same results as separate varying electromagnetic signals, including spinal cord stimulation or peripheral nerve stimulation.

Abstract: Far field telemetry communications are conducted during recharge sessions between an external device and an implantable medical device. The two devices may not have been previously paired together for far field telemetry and may have been paired with other devices for far field telemetry during previous recharge sessions and/or programming sessions. Embodiments provide for temporary bonding of the two devices for far field telemetry during the recharge session. The implantable medical device of the recharge session may maintain a programming bond with an external device other than the external device conducting the recharge session. Safeguards against establishment of inadvertent programming sessions between the external device that has conducted a recharge session and implantable medical devices that may or may not be bonded to that external device are provided.

Abstract: An example system includes electrical stimulation circuitry configured to generate electrical stimulation, electrodes configured to deliver the electrical stimulation to a patient, and processing circuitry configured to determine, for a patient, a first cycling of electric stimulation doses. The processing circuitry is also configured to deliver the electric stimulation doses according the determined first cycling, receive patient feedback representing a response of the patient to the electric stimulation doses delivered according to the first cycling, determine, based on the patient feedback, a second cycling of the electric stimulation doses, and deliver the electric stimulation doses to the patient according the determined second cycling. Delivering the electric stimulation doses for the patient according to the determined second cycling consumes less power of the implanted device than delivering the electric stimulation doses for the patient according to the determined first cycling.

Abstract: The techniques of the disclosure describe example medical devices, systems, and methods for delivering electrical stimulation therapy to a patient. In one example, a medical device selects subsets of a plurality of therapy parameter sets that define electrical stimulation therapy, each subset including at least one therapy parameter set and less than all of the therapy parameter sets. Further, the medical device delivers, via a plurality of electrodes, electrical stimulation therapy according to each subset via a respective set of electrodes different from sets of electrodes of each other subset of the therapy parameter sets. The medical device iteratively delivers the electrical stimulation therapy according to the subsets of the therapy parameter sets via the respective sets of electrodes. Further, the medical device selects at least one subset of the therapy parameter sets that treat a condition of the patient for defining subsequent delivery of electrical stimulation to the patient.

Abstract: Apparatus and methods for managing pain uses a multiplexed modulation/stimulation signal to provide pain relief during spinal cord stimulation or peripheral nerve stimulation.

Abstract: A system for providing stimulation to a patient, the system comprising one or more processors. The one or more processors are configured to receive an updated program indicating a plurality of stimulation parameters to configure a medical device to apply the stimulation to the patient and generate difference information based on one or more differences between an existing program and the updated program. The one or more processors are further configured to output the difference information to configure the medical device to apply stimulation to the patient with the plurality of stimulation parameters.

Abstract: A medical system implements a seizure detection algorithm to detect a seizure based on a first patient parameter. The medical system monitors a second patient parameter to adjust the seizure detection algorithm. In some examples, the medical system determines whether a seizure for which therapy delivery is desirable occurred based on a second patient parameter. If a target seizure occurred, and the seizure detection algorithm did not detect the target seizure, the medical system adjusts the seizure detection algorithm to detect the target seizure. For example, the medical system may determine a first patient parameter characteristic indicative of the target seizure detected based on the second patient parameter and store the first patient parameter characteristic as part of the seizure detection algorithm. In some examples, the first patient parameter is an electrical brain signal and the second patient parameter is patient activity (e.g., patient motion or posture).

Abstract: An external device transfers a key to an implantable medical device over a proximity communication and then establishes a first far field communication session with the implantable medical device where the key is used for the first communication session. This first communication session may occur before implantation while the implantable medical device is positioned outside of the sterile field so that using a proximity communication is easily achieved. Once the implantable medical device is passed into the sterile field for implantation, the external device may then establish a second far field communication session with the implantable medical device where the last key that was used for the first communication session is again used for the second communication session which avoids the need for another proximity communication to occur within the sterile field.

Abstract: An example system includes electrodes configured to deliver the electrical stimulation to a patient, and a device comprising processing circuitry configured to determine, for a patient, a loading dose of electric stimulation. The processing circuitry is also configured to cause electrical stimulation circuitry' to deliver, during a first time period, the loading dose to the patient, receive patient feedback representing a response of the patient to the loading dose, determine, based on patient feedback, a maintenance dose of electrical stimulation, and cause the electrical stimulation circuitry to deliver, and during a second time period that is after the first time period, a maintenance dose of electrical stimulation. Delivering the maintenance dose of electrical stimulation consumes less power than delivering the loading dose of electrical stimulation.

Abstract: A medical device includes wake circuitry and telemetry circuitry. The wake circuitry is configured to receive a first set of data from a device associated with the medical device, where the first set of data is received at a frequency band. The wake circuitry is configured to output a set of pulses based on the first set of data. The wake circuitry is configured to detect a data pattern using the set of pulses. The wake circuitry is configured to output an activation signal in response to a determination that the data pattern satisfies a data pattern requirement. The telemetry circuitry is configured to output a second set of data in response to receiving the activation signal. The second set of data is transmitted at the frequency band. The telemetry circuitry is configured to establish a communication session with the device using the second set of data.

Abstract: Apparatus and methods for managing pain uses a multiplexed modulation/stimulation signal to provide pain relief during spinal cord stimulation or peripheral nerve stimulation.

Abstract: An external device transfers a key to an implantable medical device over a proximity communication and then establishes a first far field communication session with the implantable medical device where the key is used for the first communication session. This first communication session may occur before implantation while the implantable medical device is positioned outside of the sterile field so that using a proximity communication is easily achieved. Once the implantable medical device is passed into the sterile field for implantation, the external device may then establish a second far field communication session with the implantable medical device where the last key that was used for the first communication session is again used for the second communication session which avoids the need for another proximity communication to occur within the sterile field.

Abstract: An example 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, with the telemetry circuitry, an advertisement from the medical device. The advertisement includes connection parameters for a potential communication session with the medical device and an indication that the medical device is connected by an established communication session between the medical device and a connected device. The processing circuitry is further configured to identify the connected device using the indication of the advertisement, initiate a communication session between the telemetry circuitry and the connected device, and output, with the telemetry circuitry and using the communication session between the telemetry circuitry and the connected device, a request for information from the medical device.

Abstract: A system may measure, by one or more sensors, a biometric parameter associated with a subject. The system may determine values of a control parameter based on measuring the biometric parameter. The control parameter may include blood pressure of the subject. The system may perform a control measure based on a comparison of the values of the control parameters to a threshold. Performing the control measure may include delivering therapy treatment to the subject or outputting a notification indicating an action associated with treating a medical condition. Measuring the biometric parameter, determining the values of the control parameter, and performing the control measure may be in response to one or more trigger criteria.

Abstract: In one example, 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 determine connection parameters for a connection between the medical device and the external device based on one or more of first information detected by the external device or second information detected by the medical device. The processing circuitry is further configured to output an advertisement for the connection between the medical device and the external device based on the connection parameters and establish the connection between the medical device and the external device according to advertisement.

Abstract: In one example, 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 determine an advertising interval for communication between the external device and the medical device based on sensor information from the external device. The processing circuitry is further configured to configure the medical device to advertise at the determined advertising interval.

Abstract: Techniques for providing therapy to a patient via electrical stimulation are described. The techniques include, for example, determining, relative to a start time of providing the electrical stimulation, one or more efficacy times that correspond to an efficacy indicator, determining, according to the efficacy times, efficacy data items for the patient, comparing the efficacy data items with the efficacy indicator, and generating, based on the comparison, a prediction of an expected response to the therapy manifesting in the patient at a prospective time.

Abstract: A method includes receiving, with one or more processors, a first ambulatory velocity information of a patient while electrical stimulation with a first set of stimulation parameters is being delivered to the patient; adjusting, based on the first ambulatory velocity information and by a predetermined amount, one or more of the first set of stimulation parameters to generate an adjusted set of stimulation parameters by a predetermined amount; receiving, with the one or more processors, a subsequent ambulatory velocity information of the patient while the electrical stimulation with an adjusted set of stimulation parameters is being delivered to the patient; and generating, with the one or more processors and based on the subsequent ambulatory velocity, one or more recommended electrical stimulation parameters the patient.

Abstract: Implantable medical systems include implantable percutaneous medical leads and/or implantable medical lead extensions that have fewer conductors than distal electrodes, or distal connectors for extensions, by having one or more conductors be electrically coupled to multiple distal electrodes. The multiple distal electrodes may span a general area of a body of a patient that includes a specific point that requires therapy, such as multiple vertebral segments. Because all distal electrodes spanning the general area that are coupled to an active conductor will output the stimulation therapy, the specific point within the general area will receive the therapy even without identifying which electrode is most effective. Bipolar and unipolar stimulation modes may be used. Multiple leads may be used where each lead has more distal electrodes than conductors. Additionally, a single lead may have more distal electrodes than conductors while also carrying multiple stimulation waveforms.