Abstract: Techniques for increasing the safety of medical device programming using general purpose hardware, such as a general purpose personal computer, are described. Some embodiments include a watchdog module that is serviced by the general purpose hardware, a mediator module that monitors programming instructions from the general purpose hardware, and/or a safe mode input that may be activated by a user. In some embodiments, a system comprises an implantable medical device, an intermediate device, a computing device that communicates with the implantable medical device via the intermediate device. The intermediate device may provide any one or more of the safety measures described above. In some embodiments, the intermediate device is dedicated hardware, and critical programming functions are provided by the intermediate device, rather than the general purpose hardware.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a concentric axial view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

Abstract: The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by defining a stimulation field. After a stimulation lead is implanted in a patient, a clinician manipulates a stimulation field on the display to encompass desired anatomical regions of the patient. In this manner, the clinician determines which anatomical regions to stimulate, and the system generates the necessary stimulation parameters. In some cases, a lead icon representing the implanted lead is displayed to show the clinician where the lead is relative to anatomical regions of the patient.

Abstract: A programmer allows a clinician to identify desirable combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The clinician may create neurostimulation therapy programs that include identified desirable electrode combinations. In some embodiments, the clinician may use the programmer to select a program, such as a program identified during a neurostimulation programming session, and direct the programmer to replicate the selected program. The programmer may change one or more parameters of the selected program, such as pulse amplitude or duty cycle, when generating the copy of the selected program.

Abstract: A programming device used to program delivery of therapy to a patient by a medical device, such as an implantable neurostimulator or pump, maintains or accesses a programming history for the patient. The programming history may take the form of a record of programs, e.g., combinations of therapy parameters, tested during one or more prior programming sessions. The programming device may analyze, or otherwise use the programming history to provide guidance information to a user, such as a clinician, which may assist the user in more quickly identifying one or more desirable programs during a current programming session.

Abstract: The disclosure describes a method and system that generates an electrical field model of defined stimulation therapy and displays the electrical field model to a user via a user interface. The electrical field model is generated based upon a patient anatomy and stimulation parameters to illustrate which areas of a patient anatomical region will be covered by the electrical field during therapy. In addition, a neuron model may be applied to the electrical field model to generate an activation field model. The activation field model indicates which neurons will be activated by the electrical field in the anatomical region. These field models may be used by a clinician to determine effective therapy prior to stimulation delivery. In particular, the field models may be beneficial when programming non axi-symmetric, or three-dimensional (3D), leads which allow greater flexibility in creating stimulation fields.

Abstract: This disclosure describes techniques for displaying representations of therapy session histories with a programmer device configured to program an implantable fluid delivery device. Information regarding the session histories may be stored in a memory of the fluid delivery device. An example programmer includes a user interface comprising a display to present a representation of a plurality of therapy sessions administered by an implantable fluid delivery device to a patient, and a processor that controls the user interface to present on the display the representation of the plurality of therapy sessions. The representation may include simultaneously displayed, temporally-ordered representations of the plurality of therapy sessions, such as a graph comprising a plurality of nodes, each node corresponding to one of the therapy sessions. Horizontal locations of the nodes may correspond to relative ending dates for the corresponding therapy session, and shapes of each node may represent infusion patterns.

Abstract: A user may modify a stimulation parameter in a plurality of stimulation programs with a single adjustment. During stimulation therapy, the user, such as a patient, may desire to change a parameter of the plurality of stimulation programs. The patient may press a single button on an external programmer to make the parameter change, or global adjustment, to all of the plurality of stimulation programs. This global adjustment eliminates the need for the patient to navigate through each of the plurality of stimulation programs separately and adjust the parameter. Additionally, changing the plurality of stimulation programs may be desirable for uniform stimulation therapy between programs used by the patient. The external programmer may calculate an appropriate parameter change for each stimulation program to keep parameter ratios equal between the plurality of stimulation programs.

Abstract: Techniques for remotely titrating a therapy delivered using an implantable medical device system are disclosed. An implantable medical device delivers therapy according to a first program. The system collects patient data relating to at least one of an efficacy of, or side effects resulting from, the delivered therapy, and transmits the patient data to a remote network device. A clinician may then analyze the patient data and determine if changes to the therapy are warranted. The clinician may then transmit a programming change, e.g., a modification to the first program or a new, second program, to the implantable medical device system, and the implantable medical device may deliver therapy according to the changed programming. The process of receiving patient data and modifying the therapy programming may be repeated multiple times until the therapy is adequately titrated, e.g., until the patient data indicates adequate efficacy and/or acceptable side effects.

Abstract: In general, the invention is directed toward techniques for remotely monitoring the integrity of a medical device and its components. A remote networking device communicates with a medical device, e.g., an implantable medical device, via a network. The remote networking device sends a request for an integrity measurement to the medical device via the network, a remote network that requests a medical device to perform an integrity measurement. In response to the request, the medical device performs the requested integrity measurement. The medical device may transmit a result of the integrity measurement, e.g., a measured value, back to the remote networking device via the network.

Abstract: The disclosure is directed to techniques for remote management of information relating to therapy delivered to a patient by an implantable medical device (IMD). A remote monitoring system for therapy programming includes an IMD that delivers therapy, e.g., neurostimulation, drug therapy, or both, to a patient, an external programming device associated with the IMD, such as a patient programmer, and a remote networking device that receives usage information from the external programming device. The external programming device communicates with the IMD via local, wireless communication, and the remote networking device receives usage information from the external programming device via a network. The usage information includes information that relates to use of therapy by the patient, use of features of the external programming device and the IMD, or use of navigation patterns of a user interface of the external programming device.

Abstract: Techniques for remotely calibrating an implanted patient sensor with a remote networking device are described. In some embodiments, the sensor is a component of an implantable medical device (IMD). The remote networking device communicates with the IMD via a network to which the IMD and/or external programmer is connected. The IMD may transmit sensor information to the remote networking device when the IMD detects a problem with the sensor or when the patient indicates that therapy is not correctly selected for different activities. New calibration settings may be remotely generated by directly interrogating the sensor and/or communicating with the patient in order to associate sensor output with patient activities, motions, or postures.

Abstract: The disclosure is directed to transmitting power source usage information regarding a power source of an implantable medical device (IMD) to a remote networking device via a network. The IMD operates on power supplied by a power source, such as a battery, within the housing of the IMD. The use of the power source may be monitored remotely in order to maintain therapy. Power source usage information may include power source recharge patterns such as frequency of recharging events, length of recharging events, period between recharging events, discharge state of the power source, and degree of coupling between primary and secondary coils during recharging. The IMD, or an external device used with the IMD, may generate, store, and transmit the power source usage information to the remote networking device. Action requests may be transmitted from the remote networking device via the network based upon the power source usage information.

Abstract: Techniques for automatically generating neurostimulation therapy program groups are disclosed. The techniques may include receiving rating information and information describing actual therapy effects for a plurality of tested programs, and receiving target therapy data describing target therapy effects. The techniques may include automatically generating plurality of program groups based on the rating information and a comparison of actual effects to the target therapy effects. Actual effects and target therapy effects may be, for example, actual paresthesia areas and target paresthesia areas. The techniques may also include determining whether a sufficient number of programs have been tested to generate a desired number of programs groups and, if a sufficient number have not been tested, automatically generating additional programs based on the tested programs, and automatically generating program groups from the tested and automatically generated programs.

Abstract: A user may modify a stimulation parameter in a plurality of stimulation programs with a single adjustment. During stimulation therapy, the user, such as a patient, may desire to change a parameter of the plurality of stimulation programs. The patient may press a single button on an external programmer to make the parameter change, or global adjustment, to all of the plurality of stimulation programs. This global adjustment eliminates the need for the patient to navigate through each of the plurality of stimulation programs separately and adjust the parameter. Additionally, changing the plurality of stimulation programs may be desirable for uniform stimulation therapy between programs used by the patient. The external programmer may calculate an appropriate parameter change for each stimulation program to keep parameter ratios equal between the plurality of stimulation programs.

Abstract: A selection of parameter configurations for a neurostimulator using decision trees may be employed by a programming device to allow a clinician or other user to select parameter configurations, and then program an implantable neurostimulator to deliver therapy using the selected parameter configurations. The programming device executes a parameter configuration search algorithm to guide the clinician in selection of parameter configurations. The search algorithm relies on a decision tree to identify optimum parameter configurations. A decision tree is useful in classifying observations in a data set based upon one or more attributes or fields within the data. The data set includes parameter configurations matched with observed ratings of efficacy on patients of a similar indication. The learned attribute, on which classification occurs, will be the optimum parameter configuration for a set of rated configurations used to produce the classification.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. A user interface of a programmer allows a user to define stimulation therapy by interacting with one or more representations of the lead that delivers the therapy. The disclosure also contemplates selecting stimulation parameters to satisfy a user defined stimulation field by selecting one or more volumetric stimulation templates that best fit the stimulation field. The user interface may display the stimulation templates in relation to different perspectives of a lead and the stimulation field. Use of stimulation templates may simplify the determination of stimulation parameters in response to any of a variety of types of user definition of a stimulation field.

Abstract: A programming-device user interface may include multiple levels of abstraction for programming treatment settings. A stimulation zone-programming interface may be at a highest level of abstraction and may include idealized stimulation zones. A field strength-programming interface may be at a middle level of abstraction and may include electromagnetic field-strength patterns generated by the stimulation zones, and/or electrode settings, and a depiction of how the electromagnetic fields interact with each other. An electrode-programming interface may be at a lowest level of abstraction and may depict treatment settings at an electrodes-view level. These interfaces may include a display of a stimulatable area of the patient's body. The display may include a depiction of leads and/or the underlying physiology, such as a depiction of a portion of a spine. Algorithms map treatment settings from one level of abstraction to settings at one or more other levels of abstraction.

Abstract: Techniques for performing lead functionality tests, e.g., lead impedance tests, for implantable electrical leads are described. In some of the described embodiments, an implantable medical device determines whether a patient is in a target activity state, e.g., an activity state in which lead impedance testing will be unobtrusive, such as when a patient is asleep, or capture information of particular interest, such as when the patient is active, in a particular posture, or changing postures. The implantable medical device performs the lead functionality test based on this determination. Additionally, in some embodiments, the implantable medical device may group a plurality of measurements for a single lead functionality test into a plurality of sessions, and perform the measurement sessions interleaved with delivery of therapeutic stimulation.

Abstract: A method of programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The method further includes guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides an unwrapped two-dimensional array view of a lead and a concentric axial view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.