Abstract: Devices, systems, and techniques for mitigating error from gesture input are disclosed. A system may receive an indication of a first gesture input, determine that the first gesture input is an indicator gesture input, and, responsive to the determination that the first gesture input is the indicator gesture input, enter a gesture control mode during which the system is configured to control one or more actions related to a medical procedure. Only during the gesture control mode, the system may receive an indication of a second gesture input associated with the medical procedure and, responsive to receiving the indication of the second gesture input, control, based on the second gesture input, at least a portion of the medical procedure. Additionally, or alternatively, the system may employ other error mitigation techniques for gesture input related to medical procedures.

Abstract: Devices, systems, and techniques for mitigating error from gesture input are disclosed. A system may receive an indication of a first gesture input, determine that the first gesture input is an indicator gesture input, and, responsive to the determination that the first gesture input is the indicator gesture input, enter a gesture control mode during which the system is configured to control one or more actions related to a medical procedure. Only during the gesture control mode, the system may receive an indication of a second gesture input associated with the medical procedure and, responsive to receiving the indication of the second gesture input, control, based on the second gesture input, at least a portion of the medical procedure. Additionally, or alternatively, the system may employ other error mitigation techniques for gesture input related to medical procedures.

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: 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: This disclosure describes techniques that support delivering electrical stimulation current via at least two user-selected electrodes of an implantable medical device (IMD) and automatically delivering balancing current below via at least one non-selected electrode. Balancing currents delivered via the at least one non-selected electrode may be configured with an amplitude below a perception threshold of a patient. Delivery of balancing current via the at least one third electrode may allow an implantable medical device to automatically balance the total current delivered to a patient.

Abstract: Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient's condition.

Abstract: In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

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: Method, controller and system for an implantable medical device having a plurality of electrodes, the implantable medical device capable of delivering therapeutic stimulation to a patient, comprising a control module, a user interface operatively coupled to the control module, the user interface providing control of the control module by a medical professional or other user, and an electrode interface operatively coupled between the plurality of electrodes and the control module. The control module uses the electrode interface to obtain a plurality of measurements of impedance values for a plurality of selected pairs of individual ones of the plurality of electrodes. The control module flags electrodes using the plurality of measurements of impedance values of the selected pairs of individual ones of the plurality of electrodes comparative to a range, and the delivery of therapy on flagged electrodes is inhibited.

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: A programmer allows a clinician to identify 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 programmer executes an electrode combination search algorithm to select combinations of electrodes to test in a non-random order. According to algorithms consistent with the invention, the programmer may first identify a position of a first cathode for subsequent combinations, and then select electrodes from the set to test with the first cathode as anodes or additional cathodes based on the proximity of the electrodes to the first cathode. The programmer may store information for each combination tested, and the information may facilitate the identification of desirable electrode combinations by the clinician. The clinician may create neurostimulation therapy programs that include identified desirable program combinations.

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: 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: The disclosure describes a method and system that allows a user to manage multiple groups of stimulation programs that provide stimulation therapy. A physician may prepare a plurality of programs, arranged in groups that each focus on one area, that the patient may evaluate in an effort to determine if any programs provide efficacious therapy. Since the patient may be evaluating many groups by using a patient programmer, managing the groups may be difficult. The patient programmer may enable the patient to hide ineffective groups to minimize the number of groups available for therapy. In addition, the programmer may allow the patient to mark each group or program as effective or ineffective, to more easily manage groups and programs during stimulation therapy. In addition, the patient may unhide a group or program if the patient desires to reevaluate a formerly hidden option.

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: In one example, a device includes a telemetry module configured to retrieve graphics processing data from a device that is not configured to perform a rendering process using the graphics processing data and that is associated with delivering therapy to a therapy target of a patient, and a control unit configured to apply the graphics processing data while performing the rendering process to generate an image of an anatomical feature of the patient, wherein the anatomical feature comprises the therapy target for an implantable medical device, and to cause a display unit of a user interface to display the image, wherein the image of the anatomical feature is specific to the patient. The graphics processing data may include a list of vertices or a transform to be applied to a non-patient-specific anatomical atlas. The data may also include a location of a therapy element of the implantable medical device.

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: In one example, a device includes a telemetry module configured to retrieve graphics processing data from a device that is not configured to perform a rendering process using the graphics processing data and that is associated with delivering therapy to a therapy target of a patient, and a control unit configured to apply the graphics processing data while performing the rendering process to generate an image of an anatomical feature of the patient, wherein the anatomical feature comprises the therapy target for an implantable medical device, and to cause a display unit of a user interface to display the image, wherein the image of the anatomical feature is specific to the patient. The graphics processing data may include a list of vertices or a transform to be applied to a non-patient-specific anatomical atlas. The data may also include a location of a therapy element of the implantable medical device.