Abstract: The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a burst mode stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder. The burst stimulus comprises a plurality of groups of spike pulses having a maximum inter-spike interval of 100 milliseconds. The burst stimulus is separated by a substantially quiescent period of time between the plurality of groups of spike pulses. This inter-group interval may comprise a minimum of 5 seconds.

Abstract: Methods and related systems for modulating neural activity by repetitively blocking conduction in peripheral neural structures with chemical blocking agents are disclosed. Implantable systems for delivery of chemical blocking agents are disclosed. Methods and systems for reversing effects of chemical blocking agents and/or for producing substantially permanent conduction block are also disclosed.

Abstract: The present invention involves a system and methods for assessing the state of the neuromuscular pathway to ensure further nerve tests aimed at detecting at least one of a breach in a pedicle wall, nerve proximity, nerve direction, and nerve pathology, are not conducted when neuromuscular blockade levels may decrease the reliability of the results.

Abstract: Methods and apparatus are provided, for selective destruction or temporary disruption of nerves and/or conduction pathways in a mammalian body for the treatment of pain and other disorders. Apparatus comprises catheters having electrodes for targeting and affecting nerve tissue at a cellular level to reversible and irreversible nerve portion and incapacitation.

Abstract: Provided are methods and devices for interfacing with brain tissue, specifically for monitoring and/or actuation of spatio-temporal electrical waveforms. The device is conformable having a high electrode density and high spatial and temporal resolution. A conformable substrate supports a conformable electronic circuit and a barrier layer. Electrodes are positioned to provide electrical contact with a brain tissue. A controller monitors or actuates the electrodes, thereby interfacing with the brain tissue. In an aspect, methods are provided to monitor or actuate spatio-temporal electrical waveform over large brain surface areas by any of the devices disclosed herein.

Abstract: An apparatus comprises a physiologic sensing circuit and a control circuit. The physiologic sensing circuit is configured to sense an electrical respiration signal representative of respiration of a subject. The control circuit includes a respiration monitor circuit and a therapy circuit. The respiration monitor circuit is configured to extract a respiration parameter from the respiration signal and detect that a value of the respiration parameter is outside of a target value range for the respiration parameter. The therapy circuit is configured to deliver neural stimulation to the carotid sinus of the subject to stimulate respiration and to adjust respiration to maintain the value of the respiration parameter within the target value range.

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract: The invention describes a method of reducing or preventing the growth of microbes on the surface of an object, wherein the object is of such material that it can act as a working electrode. The method comprises the steps of providing a counter electrode, and a reference electrode. The object is used as the working electrode. Electrical current is passed through the working and counter electrodes. The current through the counter electrode is varied such that the electric potential of the working electrode is constant relative to the electric potential of the reference electrode. Also described is an apparatus for reducing or preventing microbes on an object using a potentiostatic device.

Abstract: An electronic system activatable by electrical power is described. The system is useful for influencing cellular functions or malfunctions in a warm-blooded mammalian subject. The system includes one or more controllable low energy HF (High Frequency) carrier signal generator circuits, one or more data processors for receiving control information, one or more amplitude modulation control generators and one or more amplitude modulation frequency control generators. The amplitude modulation frequency control generators are adapted to accurately control the frequency of the amplitude modulations to within an accuracy of at least 1000 ppm, most preferably to within about 1 ppm, relative to one or more determined or predetermined reference amplitude modulation frequencies.

Abstract: A method of modifying tissue behavior, comprising: determining a desired modification of tissue behavior for at least one of treatment of a disease, short or long term modification of tissue behavior, assessing tissue state and assessing tissue response to stimulation; selecting an electric field having an expected effect of modifying protein activity of at least one protein as an immediate response of a tissue to the field, said expected effect correlated with said desired modification; and applying said field to said tissue.

Abstract: A patch for a therapeutic electrical stimulation device includes a shoe connected to the first side of the patch, the shoe including a body extending in a longitudinal direction from a first end to a second end, and having first and second surfaces, the first end of the shoe defining at least two ports, and the first surface of the shoe defining a connection member. The patch also includes at least one conductor positioned in the ports of the first end of the shoe. The shoe is configured for sliding insertion into a receptacle defined by a controller so that the conductor is connected to the controller to deliver electrical current from the controller, through the conductor, and to the electrodes, and the connection member is at least partially captured by a detent defined by the controller in the receptacle to retain the shoe within the receptacle.

Abstract: A method and system of providing therapy to a patient using electrodes implanted adjacent tissue. The method comprises regulating a first voltage at an anode of the electrodes relative to the tissue, regulating a second voltage at a cathode of the electrodes relative to the tissue, and conveying electrical stimulation energy between the anode at the first voltage and the cathode at the second voltage, thereby stimulating the neural tissue. The system comprises a grounding electrode configured for being placed in contact with the tissue, electrical terminals configured for being respectively coupled to the electrodes, a first regulator configured for being electrically coupled between an anode of the electrodes and the grounding electrode, a second regulator configured for being electrically coupled between an anode of the electrodes and the grounding electrode, and control circuitry configured for controlling the regulators to convey electrical stimulation energy between the anode and cathode.

Abstract: There is provided a capsule-type medical device including a stimulation unit configured to apply a stimulus to a predetermined site in a body cavity.

Abstract: A tool for assisting in the planning or performing of electrical neuromodulation of a patient's spinal cord. The tool may have various functions and capabilities, including calculating a volume of activation, registering an electrode(s) shown in a radiologic image, constructing functional images of the patient's spinal anatomy, targeting of neuromodulation, finding a functional midline between multiple electrodes, determining the three-dimensional position of multiple electrodes, and/or accommodating for electrode migration. In certain embodiments, the tool can be embodied as computer software or a computer system.

Abstract: A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

Abstract: A method of operating a cardiac therapy system to deliver cardiac resynchronization therapy (CRT) pacing that includes pacing both ventricles or pacing only the left ventricle is described. Delivery of the CRT pacing to one or both ventricles is scheduled for a cardiac cycle. If an intrinsic depolarization of a ventricle is detected during a pacing delay of the ventricle, then the scheduled CRT pacing to the ventricle is inhibited for the cycle. The intrinsic interval of the ventricle, such as the intrinsic atrioventricular interval concluded by the intrinsic depolarization, is measured. During a subsequent cardiac cycle, the pacing delay of the ventricle is decreased to be less than or equal to the measured intrinsic interval. Capture of the ventricle is verified after pacing is delivered during the subsequent cardiac cycle.

Abstract: Devices and systems are disclosed for the non-invasive treatment of medical conditions through delivery of energy to target tissue, comprising a source of electrical power, a magnetically permeable toroidal core, and a coil that is wound around the core. The coil and core are embedded in a continuous electrically conducting medium, which is adapted to have a shape that conforms to the contour of an arbitrarily oriented target body surface of a patient. The conducting medium is applied to that surface by any of several disclosed methods, and the source of power supplies a pulse of electric charge to the coil, such that the coil induces an electric current and/or an electric field within the patient, thereby stimulating tissue and/or one or more nerve fibers within the patient. The invention shapes an elongated electric field of effect that can be oriented parallel to a long nerve. In one embodiment, the device comprises two toroidal cores that lie adjacent to one another.

Abstract: A TENS apparatus includes a portable TENS device having a housing with a lower surface, a pair of integral electrodes that are incorporated in the lower surface of the housing, and a pulse driver that is located within the housing and adapted to generate a program of pulse waveforms, each of which is an asymmetrical biphasic square waveform.

Abstract: This document provides methods and materials for modulating afferent nerve signals to treat medical conditions such as CHF, CHF respiration, dyspnea, peripheral vascular disease (e.g., peripheral arterial disease or venous insufficiency), hypertension (e.g., age-associated hypertension, resistant hypertension, or chronic refractory hypertension), COPD, sleep apnea, and chronic forms of lung disease where muscle dysfunction is a part of the disease pathophysiology. For example, methods and materials involved in using electrical and/or chemical techniques to block or reduce afferent nerve signals (e.g., nerve signals of group III and/or IV afferents coming from skeletal muscle and/or the kidneys) are provided.

Abstract: An apparatus and method for mineralising demineralised and hypo-mineralised biological material such as tooth or bone. The apparatus has a probe electrode for receiving a mineralisation agent and a counter electrode. It is also provided with a controller to control the electrical signal provided to the probe such that the extent of mineralisation of the biological material is controlled by modulating or changing the electrical signal provided by the probe based upon the measured output of the circuit formed from the probe, counter electrode and biological material. The electrical output provides a measure of the extent of mineralisation of the biological material which is compared with data from a reference technique which gives 3D structural information on an area of interest in the biological material.

Abstract: It has been discovered that pain felt in a given region of the body can be treated by stimulating a peripheral nerve at a therapeutically effective distance from the region where pain is felt to generate a comfortable sensation (i.e., paresthesia) overlapping the regions of pain. A method has been developed to reduce pain in a painful region following limb joint replacement by stimulating a peripheral nerve innervating the painful region with an electrode inserted into tissue and spaced from the peripheral nerve. This method may be used to help alleviate postoperative pain in patients following total knee arthroplasty surgery or other limb joint replacement surgeries.

Abstract: Active rejection techniques are used to cancel MRI gradient signals in an implantable medical device. An active component placed in an input channel of the implantable medical device actively rejects MRI gradient signals received on the input channel. A sensing circuit that senses an external MRI gradient signal generates a control signal that controls the active component. For example, the control signal may be the inverse of the external MRI gradient signal. An active component that receives an input signal including a desired signal component (e.g., a cardiac signal) and an undesired MRI gradient signal component may thus use this control signal to reject the undesired MRI gradient signal component.

Abstract: A nerve overwrap for an implantable nerve stimulation system includes a flexible sheet of electrically insulative material, having an electrical resistivity of from about 108 ohm*m to about 1020 ohm*m, adapted to wrap substantially around a group of nerve stimulation electrodes.

Abstract: Exemplary systems include a stimulator configured to be implanted within a patient, the stimulator having a body defined by at least one side surface disposed in between distal and proximal end surfaces, and a connector assembly configured to be coupled to the stimulator and extend parallel to the at least one side surface of the stimulator. The connector assembly is further configured to facilitate removable coupling of a lead having one or more electrodes disposed thereon to the stimulator.

Abstract: A method of treating a non-neuropathic condition includes implanting an electrical stimulation lead near a dorsolateral funiculus of a patient, the electrical stimulation lead including a plurality of stimulation electrodes; and applying electrical stimulation energy through one or more of the electrodes of the electrical stimulation lead to the dorsolateral funiculus to treat the non-neuropathic condition.

Abstract: Methods and apparatus are provided for pulsed electric field neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly.

Abstract: A therapy program may be modified based on information indicative of a change in a therapy field, which may represent a region of a patient's tissue to which therapy is delivered. Upon receiving information indicative of a therapy field change, an algorithmic model of a present therapy field may be generated and compared to an algorithmic model of a baseline therapy field, which indicates a therapy field that provides efficacious therapy to the patient. If a characteristic of the present therapy field differs from the baseline therapy field model, the current therapy program may be modified. In another example, upon receiving information indicative of a therapy field change, the current therapy program may be modified, and an algorithmic model of a therapy field based on the modified therapy program may be compared to a baseline therapy field model to determine whether the modified therapy program is a suitable alternative.

Abstract: Apparatus is provided that includes one or more electrodes, configured to be applied to a sphenopalatine ganglion (SPG), a greater palatine nerve, a lesser palatine nerve, a sphenopalatine nerve, a communicating branch between a maxillary nerve and an SPG, an otic ganglion, an afferent fiber going into the otic ganglion, an efferent fiber going out of the otic ganglion, an infraorbital nerve, a vidian nerve, a greater superficial petrosal nerve, or a lesser deep petrosal nerve; and a control unit, configured to drive the electrodes to apply electrical stimulation to the site, and configure the stimulation to excite nervous tissue of the site at a strength sufficient to induce at least one neuroprotective occurrence selected from the group consisting of: an increase in cerebral blood flow (CBF), and a release of one or more neuroprotective substances, and insufficient to induce a significant increase in permeability of a blood-brain barrier (BBB).

Abstract: A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Abstract: The disclosure is directed to a method for implanting a medical device proximate to a target tissue site within an occipital region of a patient, such as proximate to an occipital nerve or a trigeminal nerve. The method comprises introducing an implant tool into a patient to define an insertion path to the target tissue site. The implant tool includes a shape memory cannula and a malleable needle at least partially disposed within an inner lumen of the cannula. The shape of the needle may be changed to accommodate different anatomical structures/features of the patient. Upon withdrawal of the needle from the cannula, the cannula may change shape, thereby changing the shape of the insertion path.

Abstract: An implantable electroacupuncture device (IEAD) treats a disease or medical condition of a patient through application of stimulation pulses applied at a specified acupoint or other target tissue location. In a preferred implementation, the IEAD is an implantable, coin-sized, self-contained, leadless electroacupuncture device having at least two electrodes attached to an outside surface of its housing. The device generates stimulation pulses in accordance with a specified stimulation regimen. Power management circuitry within the device allows a primary battery, having a high internal impedance, to be used to power the device. The stimulation regimen generates stimulation pulses during a stimulation session of duration T3 minutes applied every T4 minutes. The duty cycle, or ratio T3/T4, is very low, no greater than 0.05. The low duty cycle and careful power management allow the IEAD to perform its intended function for several years.

Abstract: In connection with capture detection for a heart chamber with backup pacing in a contralateral heart chamber, a cardiac signal of the first heart chamber is sensed following delivery of a pacing pulse. The cardiac response of the first heart chamber to the pacing pulse is classified based on one or more features of the sensed cardiac signal. A backup pacing pulse is delivered to a second heart chamber contralateral to the first heart chamber. For example, the timing of the delivery of the backup pacing pulse may be based on the expected or detected timing of the features used to classify the cardiac pacing response. The backup pace may be delivered within a detection window used for sensing the features indicative of the cardiac pacing response.

Abstract: The invention provides compositions, kits, and methods for treatment of neuronal injury. In one embodiment, the composition comprises a biomembrane sealing agent, such as PEG, and a bioactive agent, such as a magnesium compound. The biomembrane sealing agent and/or the bioactive agent an intravenous administration, an intramuscular administration, an intrathecal administration, a subcutaneous administration, an epidural administration, a parenteral administration, a direct application onto or adjacent to a site of the pathological condition, and any combinations thereof. Alternatively, the biomembrane sealing agent and/or the bioactive agent may be delivered from a pump or an implant.

Abstract: A system for detecting the presence of a nerve within a subject includes a stimulator configured to provide a stimulus to a portion of the subject, a sensing device configured to be placed in communication with a muscle of the subject and to generate an output signal corresponding to a monitored parameter of the muscle, the sensing device including a mechanical sensor configured to monitor a mechanical parameter of the muscle, and a receiver configured to receive the output signal from the sensing device and to determine if the output signal corresponds to the stimulus provided by the stimulator.

Abstract: A method, apparatus, and system for determining an adverse operational condition associated with a lead assembly in an implantable medical device used for providing a therapeutic electrical signal to a cranial nerve. A first impedance associated with the lead assembly configured to provide the therapeutic electrical signal to a cranial nerve is detected. A determination is made as to whether the first impedance is outside a first predetermined range. A second impedance is detected. The detection of the second impedance is performed within a predetermined period of time from the time of the detection of the first impedance. A determination is made as to whether the second impedance is outside a second predetermined range. If the first impedance is outside the first range and the second impedance is outside the second range, the implantable medical device is prevented from providing the therapeutic electrical signal.

Abstract: A system embodiment for stimulating a neural target comprises a neural stimulator, a pace detector, and a controller. The neural stimulator is electrically connected to at least one electrode, and is configured to deliver a neural stimulation signal through the at least one electrode to stimulate the neural target. The pace detector is configured to use at least one electrode to sense cardiac activity and distinguish paced cardiac activity in the sensed cardiac activity from non-paced cardiac activity in the sensed cardiac activity. The controller is configured to control a programmed neural stimulation therapy using the neural stimulator and using detected paced cardiac activity as an input for the neural stimulation therapy.

Abstract: An example includes apparatus including a non-thin-film battery, that can include an implantable housing, electronics disposed in the implantable housing, and a battery disposed in the implantable housing, the battery comprising: a plurality of cells electrically connected to one another, with at least one cell including a stack including at least one substantially planar anode having a thickness greater than 1 micrometer and at least one substantially planar cathode having a thickness greater than 1 micrometer, and a cell housing enclosing the stack of substantially planar anodes and cathodes and displacing less than approximately 0.024 cubic centimeters, wherein the plurality of cells are interconnected in at least one of series and parallel, and terminals interconnecting the battery and the electronics.

Abstract: Apparatus for applying a treatment (216) to at least one tissue of a subject is described, the apparatus comprising a transmitting unit (210) configured to transmit a wireless power signal (214), a first implant (202a), and a second implant (202b), each of the implants being configured to receive the power signal and to apply the treatment asynchronously to each other, in response to the power signal. Other embodiments are also described.

Abstract: A low-insertion force electrical connector for implantable medical devices includes a housing with a pair of opposing sidewalls each with center openings oriented generally concentrically around a center axis. An inner coil is located in a recess with a coil axis generally co-linear with the center axis of the center openings. The inner coil includes an outer diameter less than a recess diameter, and an inner diameter greater than a center opening diameter. An outer coil is threaded onto the inner coil. The outer coil has an outer diameter less than the recess diameter, and an inner diameter less than the center opening diameter. The outer coil is radially expanded within the recess in response to engagement with contact rings on the implantable medical device, such that the outer diameter of the outer coil is at least equal to the recess diameter.

Abstract: Systems, methods and devices for paired training include timing controls so that training and neural stimulation can be provided simultaneously. Paired trainings may include therapies, rehabilitation and performance enhancement training. Stimulations of nerves such as the vagus nerve that affect subcortical regions such as the nucleus basalis, locus coeruleus or amygdala induce plasticity in the brain, enhancing the effects of a variety of therapies, such as those used to treat tinnitus, stroke, traumatic brain injury and post-traumatic stress disorder.

Abstract: A neuromimetic device includes a feedforward pathway and a feedback pathway. The device operates in parallel with a suspect neural region, coupled between regions afferent and efferent to the suspect region. The device can be trained to mimic the suspect region while the region is still considered functional; and then replace the region once the region is considered dysfunctional. The device may be particularly useful in treating neuromotor issues such as Parkinson's disease.

Abstract: A neural stimulation system includes a safety control system that prevents delivery of neural stimulation pulses from causing potentially harmful effects. The neural stimulation pulses are delivered to one or more nerves to control the physiological functions regulated by the one or more nerves. Examples of such harmful effects include unintended effects in physiological functions associated with autonomic neural stimulation and nerve injuries caused by excessive delivery of the neural stimulation pulses.

Abstract: A method and apparatus for depositing a film on a biological substrate are provided. A plasma generation device includes a dielectric conduit and a high voltage electrode. The plasma generation device is placed in proximity to the biological substrate and a gas supply that includes a precursor material is directed through the dielectric conduit. An electric field generated by the potential difference between the high voltage electrode and the biological substrate ionizes at least a portion of the gas supply and causes plasma to emanate from the dielectric conduit and contact the biological substrate. The plasma induces a reaction of the precursor material to form a film that is deposited on the biological substrate.

Abstract: Apparatus and methods are provided, including a bladder stimulator that includes an elongate element adapted to pass through a urethra or adapted to pass through another opening in the bladder, an expandable body coupled to said elongate element, and an array of one or more stimulator contacts coupled to the expandable body, the array including at least one contact adapted to contact a portion of a bladder of a subject when the expandable body is inserted in the bladder and expanded. A controller stimulates the portion of the bladder by driving a pulse into the bladder via the contact, the pulse having a frequency of 5 Hz-1 kHz. Other applications are also described.

Abstract: The present disclosure describes an implantable medical device utilizing an event-triggered prognostic indicator. The disclosure describes techniques for prognostics and management of implantable medical systems to facilitate continuity of performance of sensing and therapy delivery functions by providing adequate response time to handle emerging issues prior to adverse clinical impacts. In accordance with the present disclosure, event-triggered prognostic indicators facilitate the identification of potential device conditions.

Abstract: An intravascularly-deliverable electrode assembly can be used to provide electrostimulation. The electrode assembly can include an electrostimulation circuit located in a housing, two or more elongate members coupled to the housing and configured to anchor the housing to a heart, the two or more elongate members including two or more electrodes electrically coupled to the electrostimulation circuit and controllably addressable by the electrostimulation circuit for delivery of an electrostimulation to the heart. The two or more elongate members can be sized and shaped for intravascular delivery to the heart in a first configuration, and in response to a user actuation, the two or more elongate members can move to a second configuration that is expanded relative to the first configuration to securely anchor the intravascularly-deliverable electrode assembly to the heart. Circuitry within the electrode assembly can coordinate electrostimulation, such as for delivery to sites near each electrode.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: A component of an implantable medical device comprises a body comprising at least one external surface, the body comprising at least one of titanium, titanium-based alloys, and composites thereof, and a corrosion-resistant surface region at the at least one external surface, the corrosion-resistant surface region comprising at least one of titanium nitride, dititanium nitride, and a solid solution of nitrogen dissolved in the body, wherein the corrosion-resistant surface region is formed by thermal nitridation of the body.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.

Abstract: A method of manufacturing an implantable medical lead is disclosed herein. The method may include: providing a lead body including a proximal end, a distal end, and an electrode near the distal end; provide a conductor extending between the proximal and distal ends; providing a crimp including a ribbon-like member and extending the ribbon-like member around the conductor; and mechanically and electrically connecting the ribbon-like member to the electrode.