Abstract: An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter.

Abstract: An implantable medical device having at least one functional lead which extends longitudinally, wherein the functional lead is connected to an electrode pole for the purpose of discharging therapeutic signals or detecting diagnostic signals, wherein the functional lead has a current limiting device in one longitudinal section, wherein the current limiting device has a first and a second current limiter which are switched in parallel, and wherein each current limiter is configured to prevent electrical current in the electrical lead from exceeding a pre-specified maximum value.

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

Abstract: An external charger for an implantable medical device is disclosed which can automatically detect an implant and generate a charging field. The technique uses circuitry typically present in an external charger, such as control circuitry, a Load Shift Keying (LSK) demodulator, and a coupling detector. An algorithm in the control circuitry periodically issues charging fields of short duration in a standby mode. If the coupling detector detects the presence of a conductive material, the algorithm issues a listening window during which a charging field is generated. If an LSK reply signal is received at the LSK demodulator, the external charger can charge the implant in a normal fashion. If a movement signature is detected at the LSK demodulator indicative of a predetermined user movement of the external charger, a charging field is issued for a set timing period, to at least partially charge the IPG battery to restore LSK communications.

Abstract: A stimulation system, such as a spinal cord stimulation (SCS) system, having an automated search to establish a program to treat a patient with electrical stimulation. The stimulation system includes an electrical stimulation generator, a medical lead coupled to the electrical stimulation generator, and a programmer with a communication interface, a display screen, and a user interface. The display screen displays an image of a spinal column and a position of the medical lead relative to the spinal column. The system includes an automated search that stimulates a series of regions and receives patient feedback via the user interface. The system then stimulates a series of subregions within a subset of the regions based on the feedback, receives additional feedback, and identifies a subset of the subregions location for stimulation based on the additional feedback.

Abstract: In one embodiment, a method for the controlling of the stimulation pulses being delivered via electrodes to a patient during the programming of a pulse generator using a controller device and selecting of a minimum amplitude that corresponds to the minimum amplitude for which the patient can detect stimulation; selecting an electrode combination defined in the controller device; setting the stimulation amplitude; making a determination of the amplitude for the stimulation pulses is greater than the perception amplitude, and if so, changing the amplitude of the stimulation pulses to be less than or equal to the perception amplitude; and if not or subsequent to the changing of the amplitude, changing the selected one of a plurality of electrode combinations to a different combination.

Abstract: The present disclosure describes a circuit that may be used in a non-invasive nerve stimulator. The circuit contains a signal source, a power source, an amplification source and a user interface portion. The circuit may be used in a handheld device that is applied directly to the surface of a patient or it may be used in other configurations.

Abstract: Methods and apparatus for storing data records associated with a medical monitoring event in a data structure. An implanted device obtains data and stores the data in the data record in a first data structure that is age-based. Before an oldest data record is lost, the oldest data record may be stored in a second data structure that is priority index-based. The priority index may be determined by a severity level and may be further determined by associated factors. The implanted device may organize, off-load, report, and/or display a plurality of data records based on an associated priority index. Additionally, the implanted device may select a subset or composite of physiologic channels from the available physiologic channels based on a selection criterion.

Abstract: A procedure electrically stimulates a nerve or group of nerves. Unlike conventional systems this procedure is tuned to target a large or small group of neurons using noninvasive electromagnetic induction. This system is capable of doing this by using the principles of the alternating current in a capacitance inductance series resonance circuit. In this system the nerve resonator treats the neuron like a thin conductor placed between the plates of a capacitor in series with an inductor and then tuned to resonate with the appropriate frequency of alternating current. The system could also be inductance tuned for a given frequency. Once the system is tuned, the current amplitude in the entire circuit including the thin conductor or nerve fiber can be externally controlled.

Abstract: An apparatus comprises a therapy circuit configured to provide electrical neural stimulation therapy to a subject using a first set of a plurality of implantable electrodes, a switching circuit communicatively coupled to the therapy circuit and configured to change the delivery of therapy among the plurality of implantable electrodes, and a control circuit. The control circuit is configured to initiate delivery of the neural stimulation therapy to a first subset of the first set of electrodes during a therapy session, change the therapy delivery from the first subset of electrodes to at least a second subset of electrodes of the first set of the plurality of implantable electrodes, and recurrently alternate the therapy delivery between the first and second subsets of electrodes during the same therapy session.

Abstract: An external charger system is disclosed comprising an external charger with an internal charging coil, as well as an output port coupleable to one of a plurality of types of external accessory charging coils of varying shapes and sizes. If the internal charging coil of the external charger is sufficient for a given patient's charging needs, the accessory charging coils may be detached from the external charger, and the external charger may serve as a standalone self-contained external charger. The external charger can automatically detect which of the plurality of types of accessory charging coils is connected, and can adjust its operation accordingly. This versatile design allows the external charger system to be used by large numbers of patients, even if their particular implant charging scenarios are different.

Abstract: Provided is an implanted hearing instrument having reduced sensitivity to vibration. In this regard, the instrument differentiates between the desirable and undesirable signals within an implanted microphone response. In one arrangement, an observer identifies a current operating state of the implanted hearing instrument and one or more cancellation filters are adjusted based on the current operating state. The cancellation filter(s) are used to reduce undesired signals form the implanted microphone response. In a first arrangement, the output of the implanted hearing instrument may be filtered and removed from the implanted microphone response to reduce or substantially eliminate feedback in the microphone signal provided to an implanted signal processor.

Abstract: A system and method of providing therapy to a patient using a plurality of electrodes implanted within the patient. A virtual multipole configuration is defined relative to the plurality of electrodes. The distance between each of a group of the electrodes and a virtual pole of the virtual multipole configuration is determined. A stimulation amplitude distribution is determined for the electrode group based on the determined distances, thereby emulating the virtual multipole configuration. Electrical energy is conveyed from the electrode group in accordance with the computed stimulation amplitude distribution.

Abstract: A system and method for programming a neurostimulation device coupled to a plurality of electrodes implanted adjacent tissue of a patient are provided. A first electrode configuration corresponding to a first mode of programming the neurostimulation device is defined. A second programming mode of programming the neurostimulation device different from the first programming mode is selected. A second electrode configuration is defined based on the first electrode configuration in response to the selection of the second programming mode. The neurostimulation device is programmed using the second programming mode.

Abstract: The invention relates to an electrical stimulation device (1) with a stimulator (2), containing a generator (3) for generating electrical stimulation impulses with defined stimulation parameters, and a voltage supply (4) for supplying the generator (3) with electrical energy, and with at least two needle electrodes (5) for insertion into the skin surface of an area that is to be stimulated, which needle electrodes (5) are connected to the stimulator (2). According to the invention, the needle electrodes (5) are arranged in a common electrode housing (6) and are connected to the stimulator (2), preferably releasably, via a line (7).

Abstract: Neurostimulators, neurostimulation systems, and methods for providing therapy to a patient. A neurostimulation system stores reference measurements and reference stimulation parameter sets respectively associated with the reference measurements. A new measurement of least one environmental parameter indicative of a change in a therapeutic environment is taken. Whether the new measurement matches one of the stored reference measurements is determined. If a match is determined, stimulation energy is conveyed from the neurostimulation system to the patient in accordance with the stimulation parameter set corresponding to the matching reference measurement.

Abstract: In one embodiment, a method for facilitating programming of an implantable pulse generator (IPG) by an external programming device, the method comprises: receiving input from a user by the external programming device to calibrate electrode combinations at a plurality of locations along one or more stimulation leads implanted within the epidural space of a patient; controlling the IPG by the external programmer to apply stimulation to the patient via the electrode combinations; receiving input from a user by the external programming device that indicates values of a respective perception stimulation threshold at each location of the plurality of locations; receiving input from a user by the external programming device that indicates values of a respective bilateral stimulation threshold at each location of the plurality of locations; calculating positions by the external programming device of each of the plurality of locations using the perception stimulation thresholds and the bilateral stimulation thresholds

Abstract: The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a combination of burst and tonic stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder.

Abstract: Some embodiments provide a system, comprising a peripheral nerve field modulation (PNFM) therapy delivery system, PNFM electrodes configured to be implanted subcutaneously, and a controller. The PNFM electrodes are electrically connected to the PNFM therapy system. The PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields. The controller is configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields. The controller includes a scheduler configured to control timing of the PNFM therapy.

Abstract: Systems and techniques that enable a user to selectively extend the time prior to providing an indication of power source depletion, e.g., allow an extended the recommended replacement time (RRT) prior to providing an elective replacement indication (ERI), are described. The user provides input, which may indicate an acceptable level of implantable medical device performance, e.g., that lesser performance for a period between a default RRT and an extended RRT is acceptable. In response to the input, the time until providing an RRT/ERI notification, or some other indication of depletion of the implantable medical device power source, may be extended.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. A programmer is configured to generate an electrical field model from selected stimulation parameters and patient anatomy data. The electrical field model indicates how the electrical field propagation would occur in the patient during therapy. In addition, the programmer may be configured to generate an activation field model from the electrical field model and a neuron model. The activation field indicates which neurons within the electrical field will be activated during the therapy. Either of these field models may be presented to the user via a user interface that also displays a representation of the lead implanted within the patient. The user interface may allow the user to adjust the stimulation therapy by manipulating displayed field or activation model representations.

Abstract: In one embodiment, a method of programming an IPG comprises providing one or several GUI screens on the programmer device, the GUI screens comprising a master amplitude GUI control for controlling amplitudes for stimsets of a stimulation program and one or several balancing GUI controls for controlling amplitudes of each stimset of the stimulation program; communicating one or several commands from the programmer device to the IPG to change the amplitude of all stimsets of the stimulation program in response to manipulation of the master amplitude GUI control, wherein the amplitude of each stimulation set is automatically calculated by a level selected through the master amplitude GUI control and one or several calibration parameters for the respective stimulation set; and automatically recalculating the one or several calibration parameters for a respective stimulation set in response to manipulation of one of the balancing GUI controls and storing the recalculated calibration parameters.

Abstract: A user, such as a clinician or the patient, uses a control device to manipulate at least one neurostimulation parameter. A mapping system uses a calibrated map to map the directional output of the control device to values of at least one stimulation parameter to allow the user to intuitively control the value of the parameter. In some embodiments, where a stimulation device is used to deliver spinal cord stimulation (SCS) therapy for example, the user manipulates a parameter to effect the location and/or strength of paresthesia experienced by the patient. In exemplary embodiments, the parameter values are combinations of electrodes, and the mapping system selects electrode combinations based on the output of the control device such that a direction of movement of paresthesia experienced by the patient corresponds to a direction of manipulation of a directional controller of the control device. The mapping system may calibrate the map based on patient paresthesia information received from a user.

Abstract: A method and system include a processor that outputs a characterization of a correspondence between a volume of estimated tissue activation and a target and/or side effect stimulation volume, and/or that provides controls by which to modify thresholds and/or amounts according to which the volume of estimated activation is to correspond to the target volume.

Abstract: A method for safeguarding an implanted medical device from the electromagnetic radiation from a diagnostic device is provided. The method includes detecting the implanted medical device by a bidirectional communication with the diagnostic device, determining a device type of the medical device with the diagnostic device, checking whether the device type of the medical device may be operated without errors under the electromagnetic radiation of the diagnostic device and initiating a protective measure if the device type of the medical device cannot be operated without errors under the electromagnetic radiation.

Abstract: A computer implemented system and method facilitates a cycle of generation, sharing, and refinement of volumes related to stimulation of anatomical tissue, such as brain or spinal cord stimulation. Such volumes can include target stimulation volumes, side effect volumes, and volumes of estimated activation. A computer system and method also facilitates analysis of groups of volumes, including analysis of differences and/or commonalities between different groups of volumes.

Abstract: A neurostimulation paddle lead, method of neurostimulation, and neurostimulation system are provided. The neurostimulation paddle lead carries a plurality of electrodes comprising at least four columns of electrodes having a spacing between two inner electrode columns less than a spacing between the inner electrode columns and adjacent outer electrode columns. The inner electrode columns may also be longitudinally offset from the outer electrode columns. The methods and neurostimulation systems steer current between the electrodes to modify a medial-lateral electrical field created adjacent spinal cord tissue.

Abstract: A control device implantable in a human body—includes a control unit and at least one electrode, said control unit being connected to each electrode to control stimulation and/or measurement thereof. The control unit includes: a timing dock; a memory storing configuration data defined to enable configuration of each electrode correlated with identifiers; a memory storing program data describing a time profile correlated with identifiers; an executor activatable to send each electrode electric pulses corresponding to a predetermined program according to a predetermined electrode configuration, according to the clock; a sequencer arranged to receive an ordered plurality of pairs, each including an electrode configuration identifier and a program identifier, and selectively to activate the executor with the electrode and program configuration pairs denoted by the pairs of identifiers received as an input, according to the order thereof and the clock.

Abstract: Devices, systems, and techniques for delivering trial stimulation therapy to a patient are disclosed. A trial neurostimulator (e.g., an IMD) may be implanted within a patient to deliver stimulation therapy during a relatively short trial period of time. This IMD may include limited circuitry and be powered by an external power source to minimize the size of the IMD within the patient. The IMD may include a non-hermetic housing capable of protecting the IMD circuitry for the trial period of time. In one example, the IMD may include a secondary coil configured to generate an electrical signal in response to a magnetic field generated by an external primary coil, circuitry configured to generate a stimulation signal in response to the electrical signal, and a non-hermetic implantable housing configured to encase or otherwise house the secondary coil and the circuitry.

Abstract: A neurostimulation system senses a signal indicative of a patient's physical state such as posture and/or activity level. In various embodiments, a stored value for each of stimulation parameters controlling delivery of neurostimulation is selected according to the patient's physical state. In various embodiments, values of the stimulation parameters are approximately optimized for each of a number of different physical states, and are stored for later selection.

Abstract: Selective high-frequency spinal chord modulation for inhibiting pain with reduced side affects and associated systems and methods are disclosed. In particular embodiments, high-frequency modulation in the range of from about 1.5 KHz to about 50 KHz may be applied to the patient's spinal chord region to address low back pain without creating unwanted sensory and/or motor side affects. In other embodiments, modulation in accordance with similar parameters can be applied to other spinal or peripheral locations to address other indications.

Abstract: A controlled switching module (40, 42), for a multielectrode lead for an active implantable medical device, which connects a detection/stimulation electrode (28, 30) to one or the other conductor (36, 38) of a two-wire line. Two volatile controlled switches (52, 54), for example, complementary MOS associated with at least one non-volatile programmable memory component (68, 70), for example, a suspended nanotube cell or a magnetic tunnel junction cell, supply two previously programmed stable open or closed states. A generator maximum-minimum circuit (58) is coupled to the conductors at the input, and to the controlled switches at the output for selectively controlling them via the corresponding non-volatile memory component (68, 70).

Abstract: A device and method for programming an implantable pulse generator. In one embodiment, commands are entered designating implantable pulse generator programming variables into programmer memory. At least some of the commands are transformed into an executable macro. The macro is stored in the programmer memory. The macro is executed to transmit the programming variables to the implantable pulse generator.

Abstract: This disclosure describes antenna structures for use with implantable medical devices (IMDs). The IMD may include a housing that hermetically encloses electronic components of the IMD and a fixation mechanism that attaches the IMD to a target location within a patient, such as a wall of a vessel. The fixation mechanism may function as a radiating element of an antenna of the IMD. The fixation mechanism may be attached to a housing of the IMD with two different members. One member may be an anchoring structure that mechanically anchors the fixation mechanism to the housing. The second member may be a connector that electrically connects the fixation mechanism to the housing such that the fixation mechanism is configured to transmit and/or receive communication signals with other implantable or external devices.

Abstract: A medical device for use in providing therapy to a patient by bridging or otherwise extending the range of an external device for wirelessly connecting to a medical device, such as an implanted medical device for providing stimulation therapy to a patient

Abstract: Devices, systems and methods are provided for treating migraine headaches and other conditions by non-invasive electrical stimulation of nerves and other tissue. A hand-held device includes a housing with a controller having a signal generator, an electrode for delivering electrical signals, and a conductive surface configured as a return path for the electrical signals. In certain implementations, the electrode is repositionable with respect to the housing. The patient can self-apply the hand-held device by pressing it against areas in need of pain relief. The device may include a pressure-sensitive gating switch to control delivery of the stimulation therapy. In certain embodiments, the electrode is a rollerball electrode. The device may include a chamber for retaining and dispensing conductive gel to the therapy site. In certain approaches, the device includes an electrode support for coupling an electrical stimulation system to the head for hands-free electrical stimulation therapy.

Abstract: A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect.

Abstract: An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein.

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

Abstract: An implantable medical device for use in a patient management system is described, including a sensor capable of measuring a body characteristic and generating a data signal describing the measurement, and a processor configured to analyze the data signal and identify one or more significant events that warrant attention for the well-being of a patient. The implantable medical device further includes a first non-rechargeable battery configured to power at least the sensor and the processor. In addition, a first communications unit is configured to be powered by the first non-rechargeable battery and includes a wireless transmitter capable of establishing a first communications link with a host computer using an external local receiver, when said first wireless transmitter is within a short-range telemetry communication range of said local receiver, to deliver notification of the significant events to the host computer.

Abstract: Polling mechanism in a medical implant based system. A method for operating a receiver includes searching for a signal by a receiver. The method further includes entering into an inactive state for a predefined time interval, if the signal is not detected. The method also includes altering at least one of sensitivity and the predefined time interval if number of times the searching is performed without detecting the signal exceeds a threshold. Moreover, the method includes searching for the signal with at least one of altered sensitivity and altered predefined time when the receiver enters into an active state.

Abstract: An implantable pulse generator includes a current steering capability that allows a clinician or patient to quickly determine a desired electrode stimulation pattern, including which electrodes of a group of electrodes within an electrode array should receive a stimulation current, including the amplitude, width and pulse repetition rate of such current. Movement of the selected group of electrodes is facilitated through the use of remotely generated directional signals, generated by a pointing device, such as a joystick. As movement of the selected group of electrodes occurs, current redistribution amongst the various electrode contacts takes place. The redistribution of stimulus amplitudes utilizes re-normalization of amplitudes so that the perceptual level remains fairly constant. This prevents the resulting paresthesia from falling below the perceptual threshold or above the comfort threshold.

Abstract: An intra-pericardial medical device is provided that comprises a lead body having a proximal portion, a distal end portion, and an intermediate portion extending between the proximal portion and the distal end portions. An intra-pericardial medical device further includes the control logic housed with the lead body and an energy source housed within the lead body. A stimulus conductor is included and extends along the lead body. An electrode is joined to the stimulus conduct near the distal end portion, where the electrode configured to deliver stimulus pulses. A telemetry conductor is provided within the lead and extends from the proximal portion and along the intermediate portion of the lead body. The telemetry conductor is wound into a series of coil groups to form inductive loops for at least one of receiving and transmitting radio frequency (RF) energy.

Abstract: A system includes a controller module, which includes a storage device, a controller, a modulator, and one or more antennas. The storage device is stored with parameters defining a stimulation waveform. The controller is configured to generate, based on the stored parameters, an output signal that includes the stimulation waveform, wherein the output signal additionally includes polarity assignments for electrodes in an implantable, passive stimulation device. The modulator modulates a stimulus carrier signal with the output signal to generate a transmission signal.

Abstract: A method for identifying oversensing in implantable medical devices (IMDs), such as implantable cardioverter defibrillators (ICDs), is described. A near-field electrogram signal and a far-field electrogram signal are obtained via a near-field electrode pair and a far-field electrode pair. The near-field electrogram signal is compared to the far-field electrogram signal and a determination of whether oversensing exists is made based on the comparison. In some instances, a scheduled therapy is withheld in response to determining that oversensing exists.

Abstract: Subject matter includes a device comprising: an input port to receive a waveform file for a waveform to be electrically applied to one or more patients via an output port; and electronics configured to: generate the waveform having a shape, magnitude, or frequency based, at least in part, on the waveform file; and provide the waveform to the output port.

Abstract: The disclosure describes techniques for generation of proportional posture information over multiple time intervals. The techniques may include obtaining posture state data sensed by a medical device for a patient during delivery of therapy by the medical device, determining durations for which the patient occupied each of a plurality of posture states based on the posture state data, generating proportional posture information for a plurality of different time intervals based on the durations, wherein the proportional posture information for each of the time intervals indicates proportional amounts of the respective time interval in which the patient occupied the posture states, and presenting the proportional posture information to a user via a user interface.

Abstract: A healthcare communication system includes a first plurality of computer devices operable as a nurse call system. The first plurality of computer devices has core nurse call functionality. The system also includes a second plurality of computer devices communicatively coupled to the first plurality of computer devices. The first plurality of computer devices are interconnected logically and/or physically in a tiered architecture arrangement to provide fault isolation among the tiers so that faults occurring in computer devices of one tier don't affect the operability of computer devices in other tiers and so that faults occurring in any of the second plurality of computer devices don't affect the core nurse call functionality of the first plurality of computer devices.

Abstract: An improved external charger for charging the battery within or providing power to an implantable medical device is disclosed. The improved external charger includes circuitry for detecting the temperature of the external charger and for controlling charging to prevent exceeding a maximum temperature. The external charger in some embodiments includes a user interface for allowing a patient to set the external charger's maximum temperature. The user interface can be used to select either constant maximum temperatures, or can allow the user to choose from a number of stored charging programs, which programs can control the maximum temperature to vary over time. Alternatively, a charging program in the external charger can vary the maximum temperature set point automatically. By controlling the maximum temperature of the external charger during charging in these manners, the time needed to charge can be minimized while still ensuring a temperature that is comfortable for that patient.

Abstract: Various system embodiments comprise a medical device, comprising a flexible tether, a neural stimulation circuit, and a controller. The flexible tether is adapted to be fed into a patient's throat. The flexible tether includes a plurality of electrodes. The neural stimulation circuit is adapted to deliver neural stimulation. The controller is adapted to control the neural stimulation circuit to provide a neural stimulation therapy using at least one electrode from the plurality of electrodes, and to implement a neural stimulation test routine. The neural stimulation test routine is adapted to assess neural stimulation efficacy for electrode subsets of the plurality of electrodes to identify a desired electrode subset for use in delivering the neural stimulation therapy to elicit a desired response.