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: Systems and methods for detecting and/or treating nervous system disorders, such as seizures. Certain embodiments of the invention relate generally to implantable medical devices (IMDs) adapted to detect and treat nervous system disorders in patients with an IMD. Certain embodiments of the invention include detection of seizures based upon comparisons of long-term and short-term representations of physiological signals. Other embodiments include prediction of seizure activity based upon analysis of physiological signal levels. An embodiment of the invention monitors the quality of physiological signals, and may be able to compensate for signals of low signal quality. A further embodiment of the invention includes detection of seizure activity following the delivery of therapy.

Abstract: Communication sessions between external devices and implantable medical devices are tracked using a session value that is incremented for each new session and that is stored within the implantable medical device. Session logs that are created for each session may include the session value that is obtained for that session. The session value allows available session logs to be considered in the proper sequence and allows for an awareness of missing session logs. The incrementing of the session value may occur at the external device according to one convention, or at the implantable medical device according to another. The session value to be used for a given session may be the value accessed from the implantable medical device according to one convention or may be the session value that results from incrementing the session value that is accessed from the implantable medical device according to another.

Abstract: Storing data records associated with an extreme value are disclosed. Signal data is stored in a first buffer of a set of buffers. If a local extreme value for the first buffer exceeds a global extreme value, signal data is stored in a second buffer of the set of buffers. This process is repeated, wrapping around and overwriting buffers until the signal data in a current buffer does not have a local extreme value that exceeds the global extreme value. When this happens, signal data may be stored in a subsequent buffer and if a local extreme value of the subsequent buffer does not exceed the global extreme value, further signal data may be stored in the subsequent buffer in a circular manner until either an instantaneous extreme value exceeds the global extreme value or the recording period ends. In an embodiment, the extreme value may be a peak value.

Abstract: A method and apparatus is provided for handling multiple recordings that result from events in a limited memory device. The events may include various automatic and manual triggers. The method provides a mechanism for storing different configurations of data, associated with different events.

Abstract: Techniques are described for simultaneously displaying representations, such as graphical representations, of both a selected dosing program of an implantable fluid delivery device and a pending dosing program of the implantable fluid delivery device. In one example, a system includes an implantable fluid delivery device that delivers fluid to a patient according to a selected dosing program, and a programmer device that includes a user interface comprising a display to present a graphical representation of doses of fluid to be delivered to a patient via an implantable fluid delivery device, and a processor that controls the user interface to simultaneously present on the display a first indication of a selected dosing program of the implantable fluid delivery device and a second indication of a pending dosing program of the implantable fluid delivery pump. A user may therefore compare the selected dosing program with the pending dosing program.

Abstract: A programmer device includes an interface that communicates with an implantable fluid delivery device and a user interface that displays a representation of a portion of the implantable fluid delivery device and displays an indication of a location of fluid within the implantable fluid delivery device during a delivery phase, e.g., a priming or bridging phase. The user interface may display a representation of progress of the delivery phase. The user interface may display the indication of the location of the fluid within internal tubing of the implantable fluid delivery device or within a catheter of the implantable fluid delivery device. The programmer device may display the representation of the progress of the delivery phase as a simulation of the delivery phase or during the actual delivery phase of the implantable fluid delivery device. A user may therefore observe a location of fluid corresponding to progress of the delivery phase.

Abstract: Techniques are described for displaying a representation of a supplemental bolus and a representation of programmed doses of a therapy schedule for an implantable fluid delivery device with a programmer device. In one example, a device includes a user interface to present a graphical representation of doses of fluid to be delivered to a patient via an implantable fluid delivery device and a processor that controls the user interface to simultaneously present a first graphical representation of a supplemental bolus to be delivered by the implantable fluid delivery device and a second graphical representation of programmed doses of a therapy schedule of the implantable fluid delivery device, wherein at least a portion of the programmed doses of the therapy schedule follows delivery of the supplemental bolus by the implantable fluid delivery device. A user of the device may determine whether the representations indicate an excessive dosage risk to the patient.

Abstract: Systems and methods for detecting and/or treating nervous system disorders, such as seizures. Certain embodiments of the invention relate generally to implantable medical devices (IMDs) adapted to detect and treat nervous system disorders in patients with an IMD. Certain embodiments of the invention include detection of seizures based upon comparisons of long-term and short-term representations of physiological signals. Other embodiments include prediction of seizure activity based upon analysis of physiological signal levels. An embodiment of the invention monitors the quality of physiological signals, and may be able to compensate for signals of low signal quality. A further embodiment of the invention includes detection of seizure activity following the delivery of therapy.

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: A method and apparatus is provided for handling multiple loop recordings that result from events in a limited memory implantable device. The events may include various automatic and manual triggers. The method provides a mechanism for deciding the amount of information to store associated with each overlapping loop recording.

Abstract: Techniques for testing integrity of various elements of implantable medical device systems are described. Some embodiments automatically test the integrity of one or more system elements in response to detecting an event. Examples of events in response to which an integrity test may be performed include the patient being within a target activity state, a symptomatic event experienced by a patient, an external impact on the patient that exceeds a damage threshold, or an indication that the patient is receiving inappropriate therapy. Some embodiments automatically test integrity in response to failure to autonomously detect an event, which may be indicated by input from a patient. An implantable lead carrying electrodes or a therapeutic substance delivery element, such as a catheter, are examples of system elements for which integrity may be tested in some embodiments.

Abstract: Methods and devices for performing division approximation in implantable and wearable self-powered medical devices. The present invention provides rapid methods for performing an approximation of division on fixed point numbers, where the methods are easily implemented in small, low power consumption devices as may be found in implantable medical devices. One example of use is in rapidly determining the approximate ratio between foreground and background activity in seizure detection algorithms. Some methods approximate the ratio of Numerator (N) to Denominator (D) by raising 2 to the power of the difference in the number of zeros to the left of the Most Significant Set Bit (MSSB) of D vs. N. Some methods may also pad bits to the right of the approximate ratio MSSB using bits from the right of the N MSSB, and/or pre-process the smaller of D or N by rounding the value upward. Methods may be implemented in firmware and/or in discrete logic.

Abstract: Methods and devices for performing division approximation in implantable and wearable self-powered medical devices. The present invention provides rapid methods for performing an approximation of division on fixed point numbers, where the methods are easily implemented in small, low power consumption devices as may be found in implantable medical devices. One example of use is in rapidly determining the approximate ratio between foreground and background activity in seizure detection algorithms. Some methods approximate the ratio of Numerator (N) to Denominator (D) by raising 2 to the power of the difference in the number of zeros to the left of the Most Significant Set Bit (MSSB) of D vs. N. Some methods may also pad bits to the right of the approximate ratio MSSB using bits from the right of the N MSSB, and/or pre-process the smaller of D or N by rounding the value upward. Methods may be implemented in firmware and/or in discrete logic.

Abstract: Methods and apparatus for storing data records associated with an extreme value are disclosed. Signal data is stored in a first buffer of a set of buffers. If a local extreme value for the first buffer exceeds a global extreme value, signal data is stored in a second buffer of the set of buffers. This process is repeated, wrapping around and overwriting buffers until the signal data in a current buffer does not have a local extreme value that exceeds the global extreme value. When this happens, signal data may be stored in a subsequent buffer and if a local extreme value of the subsequent buffer does not exceed the global extreme value, further signal data may be stored in the subsequent buffer in a circular manner until either an instantaneous extreme value exceeds the global extreme value or the recording period ends. In an embodiment, the extreme value may be a peak value.

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: A programming system for an electronic medical device (EMD) is described. The programming system, as described in this disclosure, comprises a host computer, such as a general purpose computer in an in-clinic computer network, executing a software platform that provides an operating environment with which a user can interact to program an EMD. The software platform invokes monitoring software that ensures that the host computer satisfies criteria for safe operation of the operating environment, e.g., ensures that the host computer meets the minimum operating conditions required for reliable operation of the operating environment. In particular, the monitoring software may monitor system faults that occur during operation, as well as ensure that criteria for safe operation are satisfied prior to initiating the operating environment.

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: 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: An apparatus including a processor configured to selectively load a first operating system that controls general purpose computer functionality of the apparatus; and a second operating system different from the first operating system. The second operating system controls medical device programming functionality of the apparatus, enabling the apparatus to program a medical device including at least one implantable component.