Abstract: Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the sensing amplifier is not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals. A common mode voltage is applied to the stimulation electrodes while sensing during a recharge period where the common mode voltage approximates the stimulation pulse being received at the sensing electrodes. This common mode voltage is determined based on measuring a common mode signal for at least one of the inputs of the amplifier or by deriving the proper common mode from monitoring the output signal of the amplifier to observe the elimination of artifacts during stimulation. Blanking switches may be used to blank the sensing of the peak of the recharge period should that peak be relatively large.

Abstract: In general, this disclosure is directed to a mixer amplifier that can be utilized within a chopper stabilized instrumentation amplifier. The chopper stabilized instrumentation amplifier may be used for physiological signal sensing, impedance sensing, telemetry or other test and measurement applications. In some examples, the mixer amplifier may include a current source configured to generate a modulated current at a modulation frequency for application to a load to produce an input signal, an amplifier configured to amplify the input signal to produce an amplified signal, and a demodulator configured to demodulate the amplified signal at the modulation frequency to produce an output signal indicating an impedance of the load.

Abstract: In some examples, one or more processors determine characteristics of frequency components of a sensed bioelectrical signal. In response to determining the characteristics, the one or more processors determine therapy parameters for frequency components of a stimulation signal. The one or more processors may determine the therapy parameters based on the characteristics of the frequency components of the sensed bioelectrical signal. As another example, the one or more processors may determine the therapy parameters based on received information after the characteristics of the frequency components of the sensed bioelectrical signal are displayed to a user.

Abstract: Medical devices include a separate enclosure that houses a battery and electrically isolates the battery from external conditions such as any metal enclosures and ultimately isolates the battery from body fluids. Thus, the separate enclosure attaches to a housing of a medical device and provides for modularity of the battery which allows, for instance, different size batteries to be used with the same medical device design. The separate enclosure further prevents stimulation current from leaking back to the battery housing by providing the electrical isolation.

Abstract: Devices and methods compensate for perturbations in a stimulation signal caused by external conditions such as a magnetic field of an MRI machine so that stimulation therapy may continue in the presence of the external condition. Compensation for the perturbations during a stimulation pulse of a stimulation phase may be provided by using feedback within a stimulation current source. Perturbations during a recharge phase may be addressed by utilizing an active recharge at least when the external condition is present. Furthermore, compensation for perturbations during a recharge pulse of the active recharge phase may be provided by using feedback within a recharge current source. Passive recharge may be used instead of active recharge when the external condition is not present to preserve battery life of the stimulation device. The stimulation device may include a sensor to detect the external condition so that an appropriate mode of recharge may be chosen.

Abstract: A method for delivering optical stimulation comprises transfecting a target tissue with a light-sensitive channel protein sensitive to light in a wavelength range, delivering light in the wavelength range to the target tissue via an optical stimulation device, substantially simultaneously with delivering light to the target tissue, sensing bioelectric signals, determining a patient therapeutic state based on the bioelectric signals, and adjusting the delivery of the light to the target tissue based on the sensed patient therapeutic state.

Abstract: This disclosure describes a chopper stabilized instrumentation amplifier. The amplifier is configured to achieve stable measurements at low frequency with very low power consumption. The instrumentation amplifier uses a differential architecture and a mixer amplifier to substantially eliminate noise and offset from an output signal produced by the amplifier. Dynamic limitations, i.e., glitching, that result from chopper stabilization at low power are substantially eliminated through a combination of chopping at low impedance nodes within the mixer amplifier and feedback. The signal path of the amplifier operates as a continuous time system, providing minimal aliasing of noise or external signals entering the signal pathway at the chop frequency or its harmonics. The amplifier can be used in a low power system, such as an implantable medical device, to provide a stable, low-noise output signal.

Abstract: This disclosure describes techniques for generating stimulation current pulses that have differing pulse shapes in a medical device. A circuit architecture is described that is configured to charge a capacitor to an initial amount of charge, modulate the amount of charge stored in the capacitor based on a control signal, and generate a stimulation current pulse that has an amplitude based on the amount charge stored in the capacitor. The circuit architecture may be configured to generate complex pulse shapes, such as, e.g., steps, ramps, bursts, and combinations thereof.

Abstract: Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the sensing amplifier is not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals. A common mode voltage is applied to the stimulation electrodes while sensing during a recharge period where the common mode voltage approximates the stimulation pulse being received at the sensing electrodes. This common mode voltage is determined based on measuring a common mode signal for at least one of the inputs of the amplifier or by deriving the proper common mode from monitoring the output signal of the amplifier to observe the elimination of artifacts during stimulation. Blanking switches may be used to blank the sensing of the peak of the recharge period should that peak be relatively large.

Abstract: Devices and methods provide for the sensing of physiological signals during stimulation therapy by preventing stimulation waveform artifacts from being passed through to the amplification of the sensed physiological signal. Thus, the amplifiers are not adversely affected by the stimulation waveform and can provide for successful sensing of physiological signals between stimulation waveform pulses. A blanking switch may be used to blank the stimulation waveform artifacts where the blanking switch is operated in a manner synchronized with the stimulation waveform so that conduction in the sensing path is blocked during the stimulation pulse as well as during other troublesome artifacts such as a peak of a recharge pulse. A limiter may be used to limit the amplitude of the sensed signal, and hence the stimulation artifacts, that are passed to the amplifier without any synchronization of the limiter to the stimulation waveform.

Abstract: Devices and methods compensate for perturbations in a stimulation signal caused by external conditions such as a magnetic field of an MRI machine so that stimulation therapy may continue in the presence of the external condition. Compensation for the perturbations during a stimulation pulse of a stimulation phase may be provided by using feedback within a stimulation current source. Perturbations during a recharge phase may be addressed by utilizing an active recharge at least when the external condition is present. Furthermore, compensation for perturbations during a recharge pulse of the active recharge phase may be provided by using feedback within a recharge current source. Passive recharge may be used instead of active recharge when the external condition is not present to preserve battery life of the stimulation device. The stimulation device may include a sensor to detect the external condition so that an appropriate mode of recharge may be chosen.

Abstract: Methods of delivering optical stimulation to a target tissue from an optical stimulation device are provided. One method comprises sensing a temperature at the optical stimulation device or proximate to the optical stimulation device, and adjusting the delivery of light to the target tissue based on the sensed temperature. Another method comprises delivering the light to the target tissue with an optical light guide and sensing bioelectric signals with a sense electrode, wherein the optical light guide and the sense electrode each comprise a material that produces substantially no induced current in an electromagnetic field. Another method comprises delivering light from a light source of an optical stimulation device to a window of the optical stimulation device, delivering the light from the window to an optical light guide optically connected to the window, and delivering the light to a target tissue via the optical light guide.

Abstract: Seizure prediction systems and methods include measuring impedance and a potential within a brain of a patient to determine whether the brain is in a state indicative of a possibility of seizure. In some embodiments, at least one of the measured impedance or the measured potential may be used as a primary indication of the brain state indicative of a possibility of seizure. In one embodiment, if one of the measured impedance or the measured potential indicates a seizure, the other measurement (impedance or potential) may be used to validate whether the brain is in the state indicative of the possibility of seizure.

Abstract: This disclosure describes techniques for generating stimulation current pulses that have differing pulse shapes in a medical device. A circuit architecture is described that is configured to charge a capacitor to an initial amount of charge, modulate the amount of charge stored in the capacitor based on a control signal, and generate a stimulation current pulse that has an amplitude based on the amount charge stored in the capacitor. The circuit architecture may be configured to generate complex pulse shapes, such as, e.g., steps, ramps, bursts, and combinations thereof.

Abstract: A system and method for determining complex intercardiac impedance to detect various cardiac functions are disclosed involving a signal generator means for providing an adjustable direct current signal, a modulator for modulating the adjustable direct current signal to produce a modulated signal, at least one electrode for propagating the modulated signal across a myocardium, at least one sensor for detecting an outputted modulated signal from the myocardium, and at least one circuit to reduce the influence of process noise (aggressors) in the outputted modulated signal. The at least one circuit comprises an amplifier, a demodulator, and an integrator. The amplitude and phase of the final outputted modulated signal indicate the complex impedance of the myocardium. Changes in the complex impedance patterns of the myocardium provide indication of reduced oxygen and blood flow to the myocardium.

Abstract: Methods of delivering optical stimulation to a target tissue from an optical stimulation device are provided. One method comprises sensing a temperature at the optical stimulation device or proximate to the optical stimulation device, and adjusting the delivery of light to the target tissue based on the sensed temperature. Another method comprises delivering the light to the target tissue with an optical light guide and sensing bioelectric signals with a sense electrode, wherein the optical light guide and the sense electrode each comprise a material that produces substantially no induced current in an electromagnetic field. Another method comprises delivering light from a light source of an optical stimulation device to a window of the optical stimulation device, delivering the light from the window to an optical light guide optically connected to the window, and delivering the light to a target tissue via the optical light guide.

Abstract: A method for delivering optical stimulation comprises transfecting a target tissue with a light-sensitive channel protein sensitive to light in a wavelength range, delivering light in the wavelength range to the target tissue via an optical stimulation device, substantially simultaneously with delivering light to the target tissue, sensing bioelectric signals, determining a patient therapeutic state based on the bioelectric signals, and adjusting the delivery of the light to the target tissue based on the sensed patient therapeutic state.

Abstract: In general, this disclosure is directed to a mixer amplifier that can be utilized within a chopper stabilized instrumentation amplifier. The chopper stabilized instrumentation amplifier may be used for physiological signal sensing, impedance sensing, telemetry or other test and measurement applications. In some examples, the mixer amplifier may include a current source configured to generate a modulated current at a modulation frequency for application to a load to produce an input signal, an amplifier configured to amplify the input signal to produce an amplified signal, and a demodulator configured to demodulate the amplified signal at the modulation frequency to produce an output signal indicating an impedance of the load.

Abstract: A system and method for determining complex intercardiac impedance to detect various cardiac functions are disclosed involving a signal generator means for providing an adjustable direct current signal, a modulator for modulating the adjustable direct current signal to produce a modulated signal, at least one electrode for propagating the modulated signal across a myocardium, at least one sensor for detecting an outputted modulated signal from the myocardium, and at least one circuit to reduce the influence of process noise (aggressors) in the outputted modulated signal. The at least one circuit comprises an amplifier, a demodulator, and an integrator. The amplitude and phase of the final outputted modulated signal indicate the complex impedance of the myocardium. Changes in the complex impedance patterns of the myocardium provide indication of reduced oxygen and blood flow to the myocardium.

Abstract: A system and method for determining complex intercardiac impedance to detect various cardiac functions are disclosed involving a signal generator means for providing an adjustable direct current signal, a modulator for modulating the adjustable direct current signal to produce a modulated signal, at least one electrode for propagating the modulated signal across a myocardium, at least one sensor for detecting an outputted modulated signal from the myocardium, and at least one circuit to reduce the influence of process noise (aggressors) in the outputted modulated signal. The at least one circuit comprises an amplifier, a demodulator, and an integrator. The amplitude and phase of the final outputted modulated signal indicate the complex impedance of the myocardium. Changes in the complex impedance patterns of the myocardium provide indication of reduced oxygen and blood flow to the myocardium.