Abstract: Systems and methods selectively stimulate components of the pudendal nerve away from the sacral root to evoke desired physiologic responses in persona who lack the ability to otherwise produce these responses—e.g., maintain continence and/or produce micturition, and/or provide male/female sexuality responses, and/or provide bowel responses. The systems and methods use a multiple electrode array, or individual electrodes, placed on, in, or near the pudendal nerve. The electrode array, or individual electrodes, in association with a pulse generator, provide selective stimulation of individual fascicles within the pudendal nerve, to achieve different physiologic responses.

Abstract: Described here are devices, systems, and methods for treating one or more conditions (such as dry eye) or improving ocular health by providing stimulation to nasal or sinus tissue. Generally, the devices may be handheld or implantable. In some variations, the handheld devices may have a stimulator body and a stimulator probe having one or more nasal insertion prongs. When the devices and systems are used to treat dry eye, nasal or sinus tissue may be stimulated to increase tear production, reduce the symptoms of dry eye, and/or improve ocular surface health.

Abstract: A medical device control unit is provided. The control unit may include at least one processing device, a circuit electrically coupled to the at least one processing device, and a flexible housing configured to contain the at least one processing device and the circuit. The flexible housing may include at least one connection portion configured to engage a connector protruding from a flexible carrier, and at least one electrical contact electrically coupled to the circuit and configured to establish an electrical connection with an exposed electrical contact on the flexible carrier when the connection portion is engaged with the at least one connection portion.

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: Methods, devices and systems are provided to efficiently identify, from among a plurality of possible neurostimulation parameter sets, one or more preferred neurostimulation parameter sets that treat a targeted pain of a patient. A plurality of different neurostimulation parameter sets are tested on the patient to thereby identify those tested neurostimulation parameter sets that treat the targeted pain. Each of the tested neurostimulation parameter sets defines an electrode configuration that differs from the other tested neurostimulation parameter sets.

Abstract: An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation.

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: Various methods and apparatuses are disclosed that concern delivering electrical stimulation to a brain at a plurality of different stimulation frequencies, sensing one or more bioelectrical signals, and identifying a bioelectrical resonance response of the brain to the electrical stimulation. The bioelectrical resonance response may be identified based on a parameter of oscillation of the one or more bioelectrical signals and indicative of resonance of an area of the brain to one stimulation frequency of the plurality of stimulation frequencies. A stimulation frequency parameter for a therapy may be set based on the identified bioelectrical resonance response, wherein the stimulation frequency parameter is set at or near the one stimulation frequency.

Abstract: A device for stimulating nerves adjacent the vagina includes a nerve stimulating element coupled to a body. The nerve stimulating element is positioned to stimulate the vesical, Frankenhauser's and/or inferior hypogastric plexuses. The device may reside in the vaginal fornices.

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 neuromodulation system includes modulation output circuitry and control circuitry. The modulation output circuitry may be configured to deliver therapeutic electrical energy including therapeutic sub-threshold electrical energy and therapeutic a super-threshold electrical energy. The sub-threshold electrical energy is below a patient-perception threshold and the super-threshold electrical energy is above the patient-perception threshold. The patient-perception threshold is a boundary below which a patient does not sense delivery of the electrical energy and above which the patient does sense delivery of the electrical energy. The control circuitry is configured to control the modulation output circuitry to deliver the therapeutic electrical energy using alternating cycles of the sub-threshold electrical energy below the patient-perception threshold and the super-threshold electrical energy above the patient-perception-threshold.

Abstract: A neuro-stimulation system employs a includes a stimulator which may include electrode devices and/or vibration elements. A controller may be employed to drive the stimulating elements with an electrical signal. In response to the electrical signal, the stimulating elements deliver electrical and/or mechanical stimulation to the body part. The stimulation may be an aperiodic stimulation and/or may be a subthreshold stimulation. In one embodiment, the stimulator is disposable and the processor determines usage of the stimulator and ensures that the stimulator is limited to a certain amount of use. Neuro-stimulation systems may be applied to sensory cells of body parts during movement of the body parts to induce neuroplastic changes. Such movement may involve a variety of therapeutic applications, e.g. in stroke patient therapy.

Abstract: Protocols are provided for the use of frequency specific microcurrent in conjunction with dental or orthodontic procedures to treat or prevent inflammation induced complications. Specific protocols are disclosed for use in conjunction with gingival surgery and chronic periodontitis, implant/osseous periodontal surgery, general post operative trauma, pulpal trauma, pulpal inflammation, root canal post op, chronic osteonecrosis, osteonecrosis surgery post op, orthodontic pain prevention, and orthodontic mid-adjustment procedures.

Abstract: An apparatus and method for performing non-invasive treatment of the human face and body by electroporation in lieu of cosmetic surgery is provided. The apparatus comprises a high voltage pulse generator and an applicator having two or more electrodes in close mechanical and electrical contact with the patient's skin for applying the pulses to the patient's skin. The applicator may consist of two pieces with one electrode having a sharp tip and another having a flat surface. High voltage pulses delivered to the electrodes create at the tip of the sharp electrode an electric field high enough to cause death of relatively large subcutaneous fat cells by electroporation. Moving the electrode tip along the skin creates a line of necrotic subcutaneous fat cells, which later are metabolized by the body. Multiple applications of the electrode along predetermined lines on the face or neck create shrinkage of the skin and the subcutaneous fat volume underlying the treated area.

Abstract: Nanosecond pulsed electric field (nsPEF) treatments of a tumor are used to cause the tumor to express calreticulin and stimulate an immune response against the tumor and other tumors in a subject. An immune response biomarker can be measured, and further nsPEF treatments can be performed if needed to stimulate or further stimulate the immune response. Cancers that have metastasized may be treated. The treatment can be combined with CD47-blocking antibodies, doxorubicin, CTLA-4-blocking antibodies, and/or PD-1-blocking antibodies. Electrical characteristics of nsPEF treatments can be based on the size, type, and/or strength of tumors and/or a quantity of tumors in the subject.

Abstract: Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.

Abstract: According to an embodiment of the present disclosure, a wound dressing system is presented. The wound dressing system includes a fluid permeable support layer, the support layer configured for positioning within a wound and adapted to generally conform to a topography of the wound, and to permit exudates from the wound to pass therethrough. The wound dressing system further includes a plurality of beads supported by the support layer, the beads defining an insulated inter-connected elongate member and an electrode embedded within and extending through at least a portion of the elongate member. Also, a current is generated by an external energy source that electrically flows through the electrode.

Abstract: Described herein are devices, systems, and methods for transdermal electrical stimulation. Devices described herein can include self-contained, lightweight, and wearable components. The devices include a primary unit including a first transdermal electrode and a secondary unit including a second transdermal electrode. The device can be capable of wireless communication. The primary unit and secondary unit are placed at two locations on the skin of a user, for example on the head or neck of a user. The first and second transdermal electrodes are electrically connected. Electrical stimulation is driven between the two electrodes. The electrical stimulation induces a cognitive effect in a user of the device.

Abstract: An implantable gastrointestinal (GI) stimulation system includes an implantable medical device and at least one stimulus delivery device configured to be placed in one or more lymphatic vessels of a patient, such as the patient's thoracic duct and/or vessels branching from the thoracic duct. In one embodiment, the implantable medical device includes a GI stimulation circuit to deliver electrical stimulation pulses to one or more target regions adjacent to a lymphatic vessel through the stimulus delivery device. In one embodiment, to control obesity, the electrical stimulation pulses are delivered to the organs and/or nerves of the GI tract to create a sensation of satiety and/or to expedite food movement through the GI tract.

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: A method for automatic threshold control and detection of lead failure in an implanted medical device obtains three sensing vectors for measurement of an electrocardiogram signal. A dynamic error signal is determined from the vectors, and may be used to set a detection threshold for insufficient ECG signals, and/or to passively monitor the device for indications of lead failure without performing an impedance measurement. Passive mode operation conserves battery power and enables continuous lead integrity checks. A quality factor may also be determined from the error signal, to indicate whether or not signal measurements are valid with respect to noise levels. If the detection threshold is allowed to decay between successive features of the electrocardiogram, the decay rate may be made adaptive such that it automatically adjusts to changes in heart rate or to changes in amplitude of the electrocardiogram features.

Abstract: A pre-sutured anchor including a deformable anchor sleeve with a lumen sized to receive the therapy delivery element. An outer surface of the anchor sleeve including one or more annular compression grooves oriented generally co-axial to the lumen. At least one compression member is located in a compression groove in an open configuration. The compression member includes at least one stop. A suture material pre-tied in a self-locking compression knot extends around each compression member. The suture material includes distal ends adapted to receive a tension force that is transmitted as a radial compression force to deform the compression members and substantially engage the stop in a compressed configuration. The anchor sleeve compressively engages the therapy delivery element in the compressed configuration.

Abstract: In general, the disclosure relates to the delivery of therapy according to a detected posture state of a patient. The disclosure contemplates a variety of techniques for managing therapy delivered to a patent. In one example, the disclosure relates to a technique including delivering therapy to a patient from a medical device, wherein the therapy is delivered to the patient according to a detected posture state of the patient; and automatically adjusting at least one aspect of the therapy delivered from a medical device based at least in part on one or more of time or patient posture state behavior, wherein automatically adjusting at least one aspect of therapy comprises suspending at least one aspect of the therapy or decreasing a posture state detection frequency.

Abstract: The present application describes a retention device for anchoring a medical device within the vasculature. The device may include expandable member coupled to an intravascular medical device and proportioned for receipt within a vessel. At least a portion of the expandable member is expandable to radially engage a vessel wall and to thereby retain the medical device within the vessel. The system is suitable for a variety of intravascular devices, including but not limited to ICD's, pacemakers, and intravascular drug delivery systems.

Abstract: The disclosure relates to an apparatus and method for inducing ventricular fibrillation in a patient to facilitate defibrillation threshold testing. The apparatus includes a plurality of output capacitors that are dynamically configurable in a selected stacking arrangement that facilitates delivery of energy for inducing the ventricular fibrillation. An output of the apparatus is coupled to patient electrodes and a threshold energy level delivered by the output capacitors is determined.

Abstract: The invention is directed to a method of bonding a hermetically sealed electronics package to an electrode or a flexible circuit and the resulting electronics package, that is suitable for implantation in living tissue, such as for a retinal or cortical electrode array to enable restoration of sight to certain non-sighted individuals. The hermetically sealed electronics package is directly bonded to the flex circuit or electrode by electroplating a biocompatible material, such as platinum or gold, effectively forming a plated rivet-shaped connection, which bonds the flex circuit to the electronics package. The resulting electronic device is biocompatible and is suitable for long-term implantation in living tissue.

Abstract: Systems and devices for selectively applying electrical energy to a target region beneath a skin surface of a patient involve applying an electrical impulse to one or more electrodes on a skin surface of the patient to modulate one or more nerves at the target region, where the impulse is substantially blocked at nerves located between the target region and the skin surface such that only the nerves at the target region are modulated by the electrical impulse.

Abstract: A needle system for penetrating to or passing thought an object or an organ comprising a semiconductor die, one or more needles, wherein the needles slide over the plane of the die, one or more actuators that move the needles relative to the die plane, and one or more actuator drivers controlled by a controller wherein the controller instruct the needle to penetrate into or to pass through and/or retract from the object or organ. The needle system is used for drug delivery or blood extraction or blood analysis or glucose measurements or blood measurements or nerve system stimulus treatment or hair removal or skin lesions removal.

Abstract: An implantable control module for an electrical stimulation system includes an electronic subassembly disposed in a casing. A sealed feedthrough housing is disposed along a portion of the casing. An electrically-conductive portion of the feedthrough housing is electrically coupled to an electrically-conductive portion of the casing. Feedthrough pins extend through the feedthrough housing and couple to the electronic subassembly via conductive pathways disposed in the casing. At least a portion of the conductive pathways extend along a non-conductive substrate. An RF-diverting assembly is disposed in the casing. The RF-diverting assembly includes a feedthrough ground electrically coupled to the electrically-conductive portion of the feedthrough housing. The RF-diverting assembly also includes a plurality of capacitive elements each coupling a different one of the plurality of conductive pathways to the feedthrough ground.

Abstract: A non-invasive electrical stimulation device shapes an elongated electric field of effect that can be oriented parallel to a long nerve, such as a vagus nerve in a patient's neck, producing a desired physiological response in the patient. The stimulator comprises a source of electrical power, at least one electrode and a continuous electrically conducting medium in which the electrode(s) are in contact. The stimulation device is configured to produce a peak pulse voltage that is sufficient to produce a physiologically effective electric field in the vicinity of a target nerve, but not to substantially stimulate other nerves and muscles that lie between the vicinity of the target nerve and patient's skin. Current is passed through the electrodes in bursts of preferably five sinusoidal pulses, wherein each pulse within a burst has a duration of preferably 200 microseconds, and bursts repeat at preferably at 15-50 bursts per second.

Abstract: A non-invasive electrical stimulator shapes an elongated electric field of effect that can be oriented parallel to a long nerve, such as a vagus nerve in a patient's neck, producing a desired physiological response in the patient. The stimulator comprises a source of electrical power, at least one electrode and a continuous electrically conducting medium in contact with the electrodes. The conducting medium is also in contact with an interface element that may conform to the contour of a target body surface of the patient when the interface element is applied to that surface. When the interface element is made of insulating (dielectric) material, and disclosed stimulation waveforms are used, the power source need not supply high voltage, in order to capacitively stimulate the target nerve.

Abstract: Implantable devices containing extracellular matrix and methods of using the devices are provided.

Abstract: A method, apparatus, and system for perform dynamic detection of a lead condition associated with a lead assembly in an implantable medical device that provides a controlled current therapeutic electrical signal to a cranial nerve. A pulsed therapeutic electrical signal is provided to a portion of a patient's body. A multiplicity of feedback signals is provided. Each the signal in the multiplicity comprises a voltage signal associated with the lead assembly for a pulse in the pulsed therapeutic electrical signal. For each the feedback signal, a determination is made as to whether the voltage signal is below a predetermined threshold to create a multiplicity of voltage signal comparison results. A determination is made as to whether or not a lead condition problem exists based upon the multiplicity of voltage signal comparison results.

Abstract: A system and method for determining physiological parameters based on electrical impedance measurements is provided. One method includes obtaining electrical measurement signals acquired from a plurality of transducers coupled to a surface of an object and constructing a system matrix to define one or more relationships between the impedance measurement signals. The method also includes decomposing the system matrix to separate the electrical measurement signals.

Abstract: Devices and methods of treating a targeted body tissue by stimulating the body tissue with an electric current. In one embodiment, an apparatus includes an electrode carrier configured to be removably coupled to an interior surface of an orthosis. The electrode carrier includes a recess configured to matingly receive a portion of an electrode. The electrode carrier is electrically coupled to the electrode when the portion of the electrode is disposed within the recess. A connection member is electrically coupled to the electrode carrier and is configured to be releasably coupled to a surface of the orthosis. The electrode carrier is electrically coupled to the orthosis when the connection member is coupled to the orthosis. In some embodiments, the electrode carrier is configured to be removably coupled to the interior surface of the orthosis. In some embodiments, at least a portion of the electrode is constructed of an absorptive material.

Abstract: Methods and devices for the non-invasive treatment of neurodegenerative diseases through delivery of energy to target nervous tissue, particularly the vagus nerve. In certain embodiments, the devices include a magnetic stimulator having coils with toroidal windings, which are in contact with an electrically conducting medium that is adapted to conform to the contour of a target body surface of a patient. The coils induce an electric current and/or an electric field within the patient, thereby stimulating nerve fibers within the patient. The stimulation brings about reduction of neuroinflammation in patients suffering from conditions comprising Alzheimer's Disease, Parkinson's Disease, Multiple Sclerosis, postoperative cognitive dysfunction and postoperative delirium.

Abstract: Various embodiments concern sensing a LFP signal from one or more electrodes, measuring the amplitude of the signals over a period of time, and calculating a plurality of variance values from the amplitude, wherein each of the variance values correspond to the variance of the amplitude for a different interval of time of the period of time with respect to the other variance values. Such embodiments may further include assessing the relative level of neural activation of an area of the brain based on the variance values, wherein the area of the brain is assessed to have a relatively higher level of neural activation when the variance is relatively higher and the area of the brain is assessed to have a relatively lower level of neural activation when the variance is relatively lower.

Abstract: An embodiment uses an accelerometer to sense heart sounds, and determines heart rate information using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition.

Abstract: The present invention provides improvements to an implant, system and method using passive electrical conductors which route electrical current to either external or implanted electrical devices, to multiple target body tissues and to selective target body tissues. The passive electrical conductor extends from subcutaneous tissue located below either a surface cathodic electrode or a surface anodic electrode a) to a target tissue to route electrical signals from the target body tissue to devices external to the body; b) to implanted electrical devices to deliver electrical current to such devices, or c) to multiple target body tissues or to selective target body tissues to stimulate the target body tissues. The conductor has specialized ends for achieving such purposes.

Abstract: Apparatus (20) is provided, including a bifurcation stent (50) comprising one or more electrodes (32), the stent (50) configured to be placed in a primary passage (52) and a secondary passage (54) of a blood vessel (30), and a control unit (34), configured to drive the electrodes (32) to apply a signal to a wall (36) of the blood vessel (30), and to configure the signal to increase nitric oxide (NO) secretion by the wall (36). Other embodiments are also described.

Abstract: A therapy program for peripheral nerve field stimulation (PNFS) may be selected based on user input indicating a desired therapeutic effect for a user-specified region in which a patient feels pain. In other examples, PNFS may be programmed based on input from a user selecting at least one region from among a plurality of regions in which the patient experiences pain. In addition, the PNFS may be programmed based on user input defining an aspect of PNFS for the selected region, such as a relative intensity of PNFS delivered to at least two selected regions, a balance of PNFS between at least two regions, a desired shift in PNFS from a first region to a second region, or an extent to which a first stimulation field within a first region overlaps with a second stimulation field in a second region.

Abstract: This document discusses, among other things, a system and method for calculating a neural stimulation energy at an external patient management (EPM) system using received information about a chemical characteristic indicative of a physiological state of a subject.

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: Systems and methods for neuromonitoring a subject are described. The system may include a stimulation assembly including a pulse generator that generates one or more stimulus waveforms; an electrode array coupled to the stimulation assembly and configured to deliver a stimulation signal to nervous system of the subject; a sensing assembly adapted to acquire a signal from a subject indicative of the subject's brain activity; a power supply configured to supply power to the stimulation assembly and the sensing assembly; and a timing controller programmed to control the use of the power supply by the stimulation assembly and the sensing assembly, said timing controller being programmed to control the time the sensing assembly is powered to acquire the signal to be substantially different than the time the stimulation assembly is powered to stimulate the subject.

Abstract: A guide catheter system includes a guide catheter having a proximal end, a distal end, an outer wall and a first, second and third electrode wherein the first, second and third electrodes are spaced longitudinally apart from each other on the outer wall of the catheter, and an electrical impulse generator connected to the guide catheter wherein the electrical impulse generator includes a circuit for selecting an adjacent pair of electrodes to use as a bipolar electrode system to send an electrical impulse and a method of use thereof to treat vasospasm.

Abstract: A port for receiving a lead is defined at a first end of a connector housing of a connector assembly for an implantable electrical medical device. A lumen extends from the port along a longitudinal axis of the connector housing. At least one of a plurality of connector contacts disposed in the connector housing couples to a terminal of the lead when the lead is received by the connector housing. The connector contacts include spring contact probes spaced apart from one another along the longitudinal axis of the connector housing with at least a portion of each of the spring contact probes extending along a first transverse axis into the lumen of the connector housing. The plurality of spring contact probes physically contact the terminals of the lead solely along the first transverse axis when the lead is received by the connector housing.

Abstract: An implantable device (100) having an electronic component (110) and a biologic materials component (130). The biologic materials component has target cells in a matrix that interfaces the electronic component with the surrounding environment.

Abstract: An intravascular device for placement within an animal vessel, the intravascular device being adapted to at least one of sense and stimulate activity of neural tissue located outside the vessel proximate the intravascular device.

Abstract: Example adjustable electrodes are described. One example adjustable electrode includes two or more contacts configured to selectively deliver high frequency alternating current (HFAC) to a nerve in an amount sufficient to produce an HFAC nerve conduction block in the nerve. The example adjustable electrode also includes a logic configured to selectively control which of the two or more contacts deliver HFAC to the nerve to control whether the nerve electrode is in a first (e.g., onset response mitigating) configuration or in a second (e.g., HFAC nerve conduction block maintenance) configuration. The electrode may be used in applications including, but not limited to, nerve block applications, and nerve stimulation applications. The electrode may be adjusted by changing attributes including, but not limited to, the number, length, orientation, distance between, surface area, and distance from a nerve of contacts to be used to deliver the HFAC.

Abstract: Devices, systems, and techniques for ramping one or more parameter values of electrical stimulation are disclosed. An implantable medical device may increase or decrease a parameter value, e.g., amplitude or pulse width, over time to reach a target value of the parameter. In one example, a memory may be configured to store a plurality of amplitude ramp schedules. At least one processor may be configured to obtain a stimulation parameter set that at least partially defines an electrical stimulation therapy, select one of the plurality of amplitude ramp schedules based on a signal frequency of the stimulation parameter set, and increase an amplitude of the electrical stimulation therapy during a ramp period defined by the selected amplitude ramp schedule.