Abstract: The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination.

Abstract: In general, the invention is directed to techniques for locating an implanted object using an external antenna. The implanted object may be, for example, an internal antenna that facilitates recharging of and/or communication with an implantable medical device. An external device coupled to the external antenna drives the antenna with a plurality of waveforms. Asymmetry in the loading profile of the external antenna when it is driven by the plurality of waveforms allows the external device or another device to determine the location of the implanted object relative to the external antenna. The external device or other device may provide information to a user based on the determined location of the implanted object relative to the external antenna, such as information to help a user position the external antenna with respect to an internal antenna in embodiments in which the implanted object is an internal antenna.

Abstract: Techniques that involve generating test stimulation programs based upon specific patient feedback to guide the programming process for stimulation therapy are described. The patient describes positive effects and adverse effects of the test stimulation by listing and/or rating specific types of effects, both positive and adverse, and the location of each effect. In this manner, a programming device, i.e. a programmer, uses the feedback to generate subsequent test stimulation programs. Initially, programs with unipolar electrode configurations are tested, but the programmer may generate bipolar electrode configurations to test if the patient rates the unipolar electrode combinations poorly. After the stimulation programs are tested and rated, the programmer sorts the tested programs based upon the feedback and presents the tested programs to the user. The user selects the best tested program to use for chronic stimulation therapy.

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 for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination.

Abstract: The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination.

Abstract: This disclosure describes delivery of omnipolar electrical stimulation with an external electrical stimulator. Omnipolar electrical stimulation may involve stimulation with an electrode carried on the housing of an implantable medical device (IMD) while substantially simultaneously delivering stimulation via one or more implanted electrodes having the same polarity as the electrode on the housing. An external medical device (EMD) may simulate the IMD housing electrode with an electrode separate from the electrodes carried on leads implanted near target tissue. This electrode may be an external electrode carried on the external housing of the EMD or an external patch electrode. Alternatively, the electrode may be an implantable electrode coupled to the EMD. The conductivity of the external or implantable electrode may also be optimized to approximate the conductivity of the IMD housing electrode. This electrode coupled to the EMD may be utilized during trial stimulation or chronic, external, stimulation.

Abstract: This disclosure describes delivery of omnipolar electrical stimulation with an external electrical stimulator. Omnipolar electrical stimulation may involve stimulation with an electrode carried on the housing of an implantable medical device (IMD) while substantially simultaneously delivering stimulation via one or more implanted electrodes having the same polarity as the electrode on the housing. An external medical device (EMD) may simulate the IMD housing electrode with an electrode separate from the electrodes carried on leads implanted near target tissue. This electrode may be an external electrode carried on the external housing of the EMD or an external patch electrode. Alternatively, the electrode may be an implantable electrode coupled to the EMD. The conductivity of the external or implantable electrode may also be optimized to approximate the conductivity of the IMD housing electrode. This electrode coupled to the EMD may be utilized during trial stimulation or chronic, external, stimulation.

Abstract: In general, the invention is directed to techniques for locating an implanted object using an external antenna. The implanted object may be, for example, an internal antenna that facilitates recharging of and/or communication with an implantable medical device. An external device coupled to the external antenna drives the antenna with a plurality of waveforms. Asymmetry in the loading profile of the external antenna when it is driven by the plurality of waveforms allows the external device or another device to determine the location of the implanted object relative to the external antenna. The external device or other device may provide information to a user based on the determined location of the implanted object relative to the external antenna, such as information to help a user position the external antenna with respect to an internal antenna in embodiments in which the implanted object is an internal antenna.

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 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 that support delivering electrical stimulation via an electrode on a housing of an implantable medical device (IMD) while substantially simultaneously delivering electrical stimulation via one or more electrodes, having the same polarity as the electrode on the housing, on one or more leads engaged to the IMD. The stimulation may be constant current-based or constant voltage-based stimulation in the form of pulses or continuous waveforms. Delivery of stimulation via both a housing anode and one or more lead anodes, for example, may allow a user to control current paths between the housing electrode and the lead electrode(s) in a relative manner to achieve different electric or stimulation field shapes.

Abstract: Various programming techniques are described for medical devices that deliver electrical stimulation therapy that may include mapping between discrete electrical stimulation parameters and a graphical view of the electrical stimulation representing a stimulation zone generated by the parameters. In one example, a method includes receiving, via a programmer for an electrical stimulator, user input that graphically manipulates at least one of size and a shape of a graphical representation of at least one electrical stimulation zone displayed on the programmer, and defining a program to control delivery of electrical stimulation therapy based on the user input.

Abstract: This disclosure describes techniques that support delivering electrical stimulation via an electrode on a housing of an implantable medical device (IMD) while substantially simultaneously delivering electrical stimulation via one or more electrodes, having the same polarity as the electrode on the housing, on one or more leads engaged to the IMD. The stimulation may be constant current-based or constant voltage-based stimulation in the form of pulses or continuous waveforms. Delivery of stimulation via both a housing anode and one or more lead anodes, for example, may allow a user to control current paths between the housing electrode and the lead electrode(s) in a relative manner to achieve different electric or stimulation field shapes.

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: An implantable medical device (IMD) delivers neurostimulation therapy to a patient according to a parameter set, which may consist of a number of programs that are delivered substantially simultaneously. When programming the IMD, a clinician programmer may maintain a session log for the patient that includes a listing of programs delivered to the patient and rating information provided by a clinician and the patient for programs of the list. The listing may be ordered according to the rating information in order to facilitate the selection of programs for a parameter set. A program library that may include particularly effective programs organized according to a directory structure may be stored in a memory. The IMD and/or a patient programmer may store usage information that provides an objective assessment of therapy use by the patient, and allows a clinician to later improve the therapy based on the usage information.

Abstract: Techniques for increasing the safety of medical device programming using general purpose hardware, such as a general purpose personal computer, are described. In some embodiments, a system includes an intermediate computing device comprising an applications module. Information from the applications module, such as instructions for an implantable medical device (IMD), may be presented to a user via a user input terminal that is separate from the intermediate computing device. A user may interact with the user input terminal to select an instruction from the applications module, and the intermediate computing device may transmit the selected instruction to the IMD. In some embodiments, the intermediate computing device comprises a web server and the user input terminal comprises a web browser configured to access the web server. In other embodiments, the intermediate computing device comprises a client server and the user input terminal comprises a client.

Abstract: In general, the invention is directed to techniques for locating an implanted object using an external antenna. The implanted object may be, for example, an internal antenna that facilitates recharging of and/or communication with an implantable medical device. An external device coupled to the external antenna drives the antenna with a plurality of waveforms. Asymmetry in the loading profile of the external antenna when it is driven by the plurality of waveforms allows the external device or another device to determine the location of the implanted object relative to the external antenna. The external device or other device may provide information to a user based on the determined location of the implanted object relative to the external antenna, such as information to help a user position the external antenna with respect to an internal antenna in embodiments in which the implanted object is an internal antenna.

Abstract: In general, the invention is directed to a technique for selection of parameter configurations for a neurostimulator using neural networks. The technique may be employed by a programming device to allow a clinician to select parameter configurations, and then program an implantable neurostimulator to deliver therapy using the selected parameter configurations. The parameter configurations may include one or more of a variety of parameters, such as electrode configurations defining electrode combinations and polarities for an electrode set implanted in a patient. The electrode set may be carried by one or more implanted leads that are electrically coupled to the neurostimulator. In operation, the programming device executes a parameter configuration search algorithm to guide the clinician in the selection of parameter configurations. The search algorithm relies on a neural network that identifies potential optimum parameter configurations.