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.

Abstract: Shielded sheaths are placed over implantable medical leads and/or implantable medical lead extensions to provide shielding from electromagnetic energy and to prevent heating at the electrodes. The shielded sheaths include insulative bodies with shield layers such as conductive braided wire or conductive foil tubular structures. The shielded sheath may be implanted at the time of implanting the lead and/or lead extension. The shielded sheath may also be implanted at a later time after the lead and/or lead extension has previously been implanted. The shielded sheath may be anchored onto the lead or lead extension.

Abstract: Processing circuitry of a medical device configured to determine that a condition occurred. The condition may be associated with at least one of a patient or an implantable medical device. Responsive to determining that the condition occurred, access instructions stored at a memory for selecting an alert mode from a plurality of alert modes, then select the alert mode based on the condition. Responsive to selecting the alert mode, output, in the selected alert mode, a notification that indicates the condition occurred.

Abstract: Devices, systems, and techniques are described for adjusting therapy parameters defining electrical stimulation therapy. An example system includes a stimulation generator comprising a voltage stack configured to provide a stack voltage based on a multiplier of a battery voltage and processing circuitry. The processing circuitry receives a first set of parameter values that use a first stack voltage of the voltage stack to provide a first electrical stimulation defining a first therapy. The processing circuitry also determines, based on a second stack voltage lower than the first stack voltage, a second set of parameter values that define a second electrical stimulation, the second set of parameters defining a lower amplitude of electrical stimulation. Additionally, the processing circuitry controls the stimulation generator to deliver the second electrical stimulation according to the second set of parameter values using the second stack voltage of the voltage stack.

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: A system that includes a movement sensor configured to be implanted within a patient and generate a movement signal and processing circuitry configured to be implanted within the patient and configured to: receive the movement signal from the movement sensor and determine that the movement signal is representative of a communication from the patient. Responsive to determining that the movement signal is representative of the communication, the processing circuitry may cause an alert associated with the communication to be output to the patient. The processing circuitry may also perform an action requested by the communication.

Abstract: A stimulation engine configured to identify a fault condition in an implantable lead, including a regulator configured to deliver an electrical pulse between at least two electrodes of the implantable stimulation lead, and a sensing module configured to detect at least an initial voltage and a subsequent voltage between the at least two electrodes at different times during delivery of the electrical pulse, and compare at least the subsequent voltage to a defined threshold value representing an expected voltage at the same time during the electrical pulse to determine the presence of a fault condition.

Abstract: The techniques of the disclosure describe example medical devices, systems, and methods for interleaving a plurality of low-frequency electrical stimulation pulse trains delivered by a plurality of sets of electrodes of an implantable medical device (IMD) to effectively deliver a combined high-frequency electrical pulse train to a target tissue area. In one example, each set of the plurality of sets of electrodes has a unique anode and cathode. In another example, a clinician adjusts the size or shape of the target tissue area receiving the combined high-frequency electrical pulse train by selecting different combinations of the plurality of sets of electrodes.

Abstract: Techniques for therapy delivery are described. A processing circuit may adjust a first therapy parameter from a first level to a second level, and responsive to the adjustment of the first therapy parameter, compare a level of an evoked compound action potential (ECAP) generated from therapy delivery based on the adjusted first therapy parameter to an ECAP threshold. The processing circuit may adjust a second therapy parameter from a third level to a fourth level based on the comparison. The second therapy parameter is different than the first therapy parameter. The processing circuit may cause therapy delivery with the first therapy parameter at the second level and the second therapy parameter at the fourth level.

Abstract: In some examples, a medical device is configured to automatically determine a paresthesia threshold or a perception threshold of a patient in a second posture based on the paresthesia threshold or perception threshold of that patient in a first posture. The medical device may deliver an electrical stimulation signal to a patient and determine the paresthesia threshold or perception threshold for the patient in the first posture. The medical device may change the intensity of the electrical signal and receive an indication from the patient that they are experiencing paresthesia or perceiving the electrical stimulation signal. The medical device may then automatically determine a predicted paresthesia threshold or predicted perception threshold for a second posture based on the paresthesia threshold or perception threshold.