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: 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: Electrical stimulation therapy is provided to a patient in order to induce a patient sensation. The patient sensation may be selected from a number of patient sensations. A set of therapy parameter values are associated with each of the number of patient sensations. A user interface allows a user to adjust one or more characteristics of the patient sensation.

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: 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: The techniques of the disclosure describe example medical devices, systems, and methods for delivering stimulation therapy comprising a first set of a plurality of pulses having a first amplitude, and a second set of a plurality of pulses having a second amplitude greater than the first amplitude. The second amplitude is adjusted to an adjusted second amplitude based on second amplitude being less than or greater than activation threshold. The first amplitude is adjusted based on adjusted second amplitude, and therapy is delivered based at least one the adjusted first amplitude.

Abstract: The techniques described herein are example medical devices, systems, and methods for sensing evoked potentials in a tissue of the patient, and, based on the sensed evoked potentials, adjusting one or more parameters defining the electrical stimulation therapy delivered to the patient. In one example, a system controls delivery of an electrical stimulation therapy from an implantable medical device to a patient according to at least one therapy program, wherein the electrical stimulation therapy is configured to provide pain relief to the patient without substantially resulting in paresthesia perceived by the patient.

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: 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 delivery of electrical neurostimulation therapy to a patient are disclosed. In one example, a processor controls delivery of electrical neurostimulation therapy to a patient by an electrical neurostimulation therapy device and via a plurality of combinations of a plurality of electrodes disposed along a lead inserted across an anatomical midline of a spinal cord of the patient and angled relative to the anatomical midline, the lead connected to the electrical neurostimulation therapy device. The processor determines, based on the electrical neurostimulation therapy, a location of a physiological midline of the spinal cord. The processor selects, based on the location of the physiological midline, at least one electrode of the plurality of electrodes for subsequent delivery of electrical neurostimulation therapy to the patient. Further, the processor displays a representation of the physiological midline and the anatomical midline relative to the spinal cord.

Abstract: Techniques for delivery of electrical neurostimulation therapy to a patient are disclosed. In one example, a processor controls delivery of electrical neurostimulation therapy to a patient by an electrical neurostimulation therapy device and via a plurality of combinations of a plurality of electrodes disposed along a lead inserted across an anatomical midline of a spinal cord of the patient and angled relative to the anatomical midline, the lead connected to the electrical neurostimulation therapy device. The processor determines, based on the electrical neurostimulation therapy, a location of a physiological midline of the spinal cord. The processor selects, based on the location of the physiological midline, at least one electrode of the plurality of electrodes for subsequent delivery of electrical neurostimulation therapy to the patient. Further, the processor displays a representation of the physiological midline and the anatomical midline relative to the spinal cord.

Abstract: Electrical stimulation therapy is provided to a patient in order to induce a patient sensation. The patient sensation may be selected from a number of patient sensations. A set of therapy parameter values are associated with each of the number of patient sensations. A user interface allows a user to adjust one or more characteristics of the patient sensation.

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: 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: 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: 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: 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: 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: 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: Techniques for delivery of electrical neurostimulation therapy to a patient are disclosed. In one example, a processor controls delivery of electrical neurostimulation therapy to a patient by an electrical neurostimulation therapy device and via a plurality of combinations of a plurality of electrodes disposed along a lead inserted across an anatomical midline of a spinal cord of the patient and angled relative to the anatomical midline, the lead connected to the electrical neurostimulation therapy device. The processor determines, based on the electrical neurostimulation therapy, a location of a physiological midline of the spinal cord. The processor selects, based on the location of the physiological midline, at least one electrode of the plurality of electrodes for subsequent delivery of electrical neurostimulation therapy to the patient. Further, the processor displays a representation of the physiological midline and the anatomical midline relative to the spinal cord.