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 automatically identifying medical devices, e.g., implantable medical device, using wireless communications in order to communicate with the medical devices are described. For instance, a programming system securely discovers a set of medical devices which have the capacity to communicate using wireless communication links. The programming system may then apply one or more search heuristics to identify a set of discovered medical devices that are likely to be a medical device with which a user desires to interact. When the user selects the desired one of the identified medical devices, the programming system launches a device interaction application associated with the desired medical device. The user may use the device interaction application to interact with the desired medical device.

Abstract: An implantable medical device is capable of delivering therapeutic output to a patient. A controller, programmable by a medical professional, is operatively coupled to the implantable medical device to, in part, program the therapeutic output to be delivered to the patient. The controller has an interface allowing the medical professional to graphically select an amount of the therapeutic output to be delivered to the patient in at least one of a series of discrete timer intervals. The graphic selection may be aided by the use of a light pen or other pointing device to sketch the infusion pattern. Computer programs using algorithms may be utilized to translate the information inputted through the light pen into an infusion program.

Abstract: Changes in electrical stimulation therapy delivered via a medical device are coordinated with Functional Magnetic Resonance Imaging (fMRI) scans. In one example, a medical device delivers electrical stimulation therapy to a patient in an MRI unit, where the medical device is configured to cycle electrical stimulation therapy between a plurality of stimulation states. An indication that the medical device will cycle the electrical stimulation therapy or has cycled the electrical stimulation therapy while the patient is in the MRI unit or being imaged by the MRI unit is generated, and an MRI scan of the patient via an MRI workstation is initiated based on the indication. In another example, a medical device detects activation of an MRI scan and automatically switches stimulation states based upon the detection of the MRI scan, such that the scan is associated with a particular stimulation state.

Abstract: In some examples, a burr hole cap assembly includes one or more markers that indicate a rotational orientation of a therapy delivery member relative to the burr hole cap assembly, where the therapy delivery member extends through an opening defined by the burr hole cap assembly. In addition, in some examples, the burr hole cap assembly includes a feature that indicates the rotational orientation of the therapy delivery member after the therapy delivery member is implanted in the patient. The feature can include the one or more markers in some examples.

Abstract: The disclosure provides techniques for parameter-directed shifting of electrical stimulation electrode combinations. An external programmer permits a user to shift electrode combinations, e.g., along the length of a lead or leads. The external programmer accepts shift input and causes an electrical stimulator to shift electrode combinations as indicated by the input. Different sets of electrodes may have different electrode counts. For example, an array of electrodes carried by one lead may have a greater number of electrodes than an array of electrodes carried on another lead. The disclosure provides techniques for shifting electrode combinations among leads with different electrode counts. For example, an external programmer may execute shifts in a series of shift operations, where the number of shift operations along the length of a lead having a greater electrode count is greater than the number of shift steps along the length of a lead having a lesser electrode count.

Abstract: A programming system allows a user to program therapy parameter values for therapy delivered by a medical device by specifying a desired therapeutic outcome. In an example, the programming system presents a model of a brain network associated with a patient condition to the user. The model may be a graphical representation of a network of anatomical structures of the brain associated with the patient condition and may indicate the functional relationship between the anatomical structures. Using the model, the user may define a desired therapeutic outcome associated with the condition, and adjust excitatory and/or inhibitory effects of the stimulation on the anatomical structures. The system may determine therapy parameter values for therapy delivered to the patient based on the user input.

Abstract: Changes in electrical stimulation therapy delivered via a medical device are coordinated with Functional Magnetic Resonance Imaging (fMRI) scans. In one example, a medical device delivers electrical stimulation therapy to a patient in an MRI unit, where the medical device is configured to cycle electrical stimulation therapy between a plurality of stimulation states. An indication that the medical device will cycle the electrical stimulation therapy or has cycled the electrical stimulation therapy while the patient is in the MRI unit or being imaged by the MRI unit is generated, and an MRI scan of the patient via an MRI workstation is initiated based on the indication. In another example, a medical device detects activation of an MRI scan and automatically switches stimulation states based upon the detection of the MRI scan, such that the scan is associated with a particular stimulation state.

Abstract: Prophylactic stimulation and abortive electrical stimulation are delivered to a cranial nerve, including, e.g. an occipital or trigeminal nerve to treat symptoms of various conditions, including, e.g. occipital neuralgia or migraines.

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 cross-sectional 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: In some examples, a burr hole cap assembly includes one or more markers that indicate a rotational orientation of a therapy delivery member relative to the burr hole cap assembly, where the therapy delivery member extends through an opening defined by the burr hole cap assembly. In addition, in some examples, the burr hole cap assembly includes a feature that indicates the rotational orientation of the therapy delivery member after the therapy delivery member is implanted in the patient. The feature can include the one or more markers in some examples.

Abstract: A programming system allows a user to program therapy parameter values for therapy delivered by a medical device by specifying a desired therapeutic outcome. In an example, the programming system presents a model of a brain network associated with a patient condition to the user. The model may be a graphical representation of a network of anatomical structures of the brain associated with the patient condition and may indicate the functional relationship between the anatomical structures. Using the model, the user may define a desired therapeutic outcome associated with the condition, and adjust excitatory and/or inhibitory effects of the stimulation on the anatomical structures. The system may determine therapy parameter values for therapy delivered to the patient based on the user input.

Abstract: The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by defining a three-dimensional (3D) stimulation field. After a stimulation lead is implanted in a patient, a clinician manipulates the 3D stimulation field in a 3D environment 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 the 3D anatomical regions of the patient.

Abstract: One or more stimulation electrodes may be selected based on a bioelectrical signal sensed in a brain of a patient with a sense electrode combination that comprises at least one electrode and a physiological model that indicates one or more anatomical structures of the brain of the patient that are proximate the implanted at least one electrode. In some examples, the bioelectrical brain signal indicates which electrodes are located closest to a target tissue site. The physiological model can be generated based on a location of implanted at least one electrode within a patient and patient anatomy data, which can, for example, indicate one or more characteristics of patient tissue proximate to the implanted at least one electrode. In some example, the physiological model includes a therapy field model that represents a region of the tissue of the patient to which therapy is delivered via a selected set of electrodes.

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: Prophylactic stimulation and abortive electrical stimulation are delivered to a cranial nerve, including, e.g. an occipital or trigeminal nerve to treat symptoms of various conditions, including, e.g. occipital neuralgia or migraines.

Abstract: An apparatus and a method for producing a virtual electrode within or upon a tissue to be treated with radio frequency alternating electric current. An apparatus in accord with the present disclosure includes a supply of a conductive or electrolytic fluid to be provided to the patient, an alternating current generator, and a processor for creating, maintaining, and controlling the ablation process by the interstitial or surficial delivery of the fluid to a tissue and the delivery of electric power to the tissue via the virtual electrode. A method in accord with the present disclosure includes delivering a conductive fluid to a predetermined tissue ablation site for a predetermined time period, applying a predetermined power level of radio frequency current to the tissue, monitoring at least one of several parameters, and adjusting either the applied power and/or the fluid flow in response to the measured parameters.

Abstract: An apparatus and a method for producing a virtual electrode within or upon a tissue to be treated with radio frequency alternating electric current. An apparatus in accord with the present disclosure includes a supply of a conductive or electrolytic fluid to be provided to the patient, an alternating current generator, and a processor for creating, maintaining, and controlling the ablation process by the interstitial or surficial delivery of the fluid to a tissue and the delivery of electric power to the tissue via the virtual electrode. A method in accord with the present disclosure includes delivering a conductive fluid to a predetermined tissue ablation site for a predetermined time period, applying a predetermined power level of radio frequency current to the tissue, monitoring at least one of several parameters, and adjusting either the applied power and/or the fluid flow in response to the measured parameters.

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 cross-sectional 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: 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.