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.

Abstract: Patient input indicating the occurrence of an event and information relating to the event may be collected by a computing device. In some examples, the patient input is received via an event indication input mechanism of a medical device programmer. A clinician may review the event information to evaluate the efficacy of a therapy system (e.g., a particular therapy program or program group) or a patient's condition. In one example, a patient may activate an event indication input mechanism to indicate the occurrence of a seizure symptom, and input information relating to the seizure, such as the duration, severity, type of seizure or efficacy of a therapy system implemented to manage seizures.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

Abstract: A biostimulator system comprises one or more implantable devices and an external programmer configured for communicating with the implantable device or devices via bidirectional communication pathways comprising a receiving pathway that decodes information encoded on stimulation pulses generated by ones of the implantable device or devices and conducted through body tissue to the external programmer.

Abstract: A programming system allows a user to program therapy parameter values for therapy delivered by a medical device by specifying a desired therapeutic outcome. In an example, the programming system presents a model of a brain network associated with a patient condition to the user. The model may be a graphical representation of a network of anatomical structures of the brain associated with the patient condition and may indicate the functional relationship between the anatomical structures. Using the model, the user may define a desired therapeutic outcome associated with the condition, and adjust excitatory and/or inhibitory effects of the stimulation on the anatomical structures. The system may determine therapy parameter values for therapy delivered to the patient based on the user input.

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: 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: Therapy systems for treating a patient are disclosed. Representative therapy systems include an implantable pulse generator, a signal delivery device electrically coupled to the pulse generator, and a remote control in electrical communication with the implantable pulse generator. The pulse generator can have a computer-readable medium containing instructions for performing a process that comprises collecting the patient status and stimulation parameter; analyzing the collected patient status and stimulation parameter; and establishing a preference baseline containing a preferred stimulation parameter corresponding to a particular patient status.

Abstract: A tissue stimulation system and computer software and method of monitoring a neurostimulation lead having a plurality of electrodes implanted within a patient (e.g., adjacent the spinal cord) is provided. Neurostimulation lead models are provided, each of which includes estimated electrical parameter data (e.g., electrical field potential data) corresponding to a predetermined position of the neurostimulation lead. Electrical energy is transmitted to or from the electrodes, and electrical parameter data (e.g., electrical field potential data) is measured in response to the transmitted electrical energy. The measured electrical parameter data is compared with the estimated electrical parameter data of each of the neurostimulation lead models, and a position of the neurostimulation lead is determined based on the comparison.

Abstract: This disclosure describes techniques for programming stimulation therapy programs according to therapy targets (e.g., symptoms or areas of pain) in a patient to which they are applied. Several programs can be programmed for each therapy target, stored on an implantable medical device, and retrieved later by a programmer to modify, edit, delete, create, and/or select a therapy program for each of the therapy targets. Each therapy target is independent from the other therapy targets, and a user can select or change a program under one therapy target without affecting programs under the other therapy targets. During programming, a user can specify parameters for each program applicable to only that program, and can specify parameters for each therapy target applicable to every program associated with that therapy target. The organization of programs into slots and the selection of a program in each slot may be manual or automated.

Abstract: A medical device system and method configure a medical device according to a configuration definition. The configuration definition includes an allowable status and a function status for each of a number of medical device functions. The medical device configuration is updated automatically in response to being interrogated by a programmer configured to update the device configuration. The device configuration is updated by updating the function status for at least one of the medical device functions in response to the allowable status for the medical device function.

Abstract: Devices, systems, and methods incorporate the most-used functions of a electrical stimulator's controller into a small, thin pocket controller that is not only comfortable to carry in a pocket, but can also be attached to a key ring, lanyard, or other such carrying device for ease of daily use. A separate patient controller charger is used to charge and control the implanted medical device.

Abstract: An electrical stimulation apparatus including a medical device. The medical device includes: a housing component having at least one electrically conductive area. The medical device includes a plurality of conductors configured to be electrically coupled to a distal electrode array. The electrode array are implantable in a human body. The medical device includes a stimulation circuit positioned inside the housing component. The stimulation circuit includes a plurality of controllable stimulation channels. A first subset of the stimulation channels is electrically coupled to the conductors. A second subset of the stimulation channels is electrically coupled to the electrically conductive area of the housing component. The stimulation circuit is operable to simultaneously create a first stimulation path in the electrode array and a second stimulation path that extends from the electrode array to the housing component.

Abstract: Devices, systems, and methods incorporate the most-used functions of a electrical stimulator's controller into a small, thin pocket controller that is not only comfortable to carry in a pocket, but can also be attached to a key ring, lanyard, or other such carrying device for ease of daily use. A separate patient controller charger is used to charge and control the implanted medical device.

Abstract: Embodiments of the invention are directed to systems and methods for programming implantable medical devices, amongst other things. In an embodiment, the invention includes a method of programming an implantable medical device. The method can include gathering parameter data representing a set of previously programmed parameter values from a plurality of implanted medical devices. The method can further include performing association analysis on the parameter data to form a set of association rules. The method can further include suggesting parameter choices to a system user regarding a specific patient based on the set of association rules. In an embodiment, the invention can include a medical system including a server configured to perform association analysis on a set of data representing previously programmed parameter values from a plurality of implanted medical devices to derive a set of association rules. Other embodiments are also included herein.

Abstract: A medical device system includes at least one controllable patient-worn or patient-carried medical device, and a plurality of controller devices that are capable of independently controlling features or functions of the patient medical device. Control commands and other data is wirelessly communicated among the patient medical device and the multiple controller devices. A number of techniques, protocols, and other measures are provided to coordinate wireless communication between the various devices in a medical device system. These control command coordination processes address situations where conflicting, redundant, or concurrent control commands might be independently issued by the multiple controller devices.

Abstract: Detecting patterns in sensed implantable medical device (IMC) data is described. One implementation involves an IMD that includes a data-driven pattern detection network embodied on the IMD to detect a pattern from sensed patient data. The IMD also includes one or more algorithms embodied on the IMD to utilize the pattern to effect patient therapy.

Abstract: In one embodiment, a method for defining a stimulation program for electrical stimulation of a patient, the method comprising: providing a single screen user interface that comprises a first plurality of controls and a second plurality of controls, the first plurality of controls allowing selection of multiple stimulation parameters for a plurality of stimulation sets, the second plurality of controls allowing selection of multiple stimulation parameters defining burst stimulation and tonic stimulation; receiving user input in one or more of the second plurality of controls; and automatically modifying parameters for one or more stimulation sets in response to receiving the user input in one or more of the second plurality of controls and modifying values displayed in one or more controls of the first plurality of controls according to the modified parameters, the modified parameters reflecting a stimulation program that includes an interleaved pattern of burst stimulation and tonic stimulation for delivery t

Abstract: A tibial nerve stimulation device including a percutaneous electrode for inserting adjacent a stimulation site of a patient and a neurostimulator unit attachable to a transcutaneous electrode configured to be applied to skin adjacent the stimulation site. The neurostimulator unit includes a pulse generator electrically coupled to the percutaneous needle electrode and transcutaneous electrode and a microcontroller in communication with the pulse generator for monitoring a number of available treatment credits and activating the pulse generator, each available treatment credit corresponding to a treatment session and the pulse generator operable to be activated for performing the treatment session when the number of available treatment credits is at least one. A computer system is operable to communicate with the microcontroller of the neurostimulator unit for receiving a treatment credit request and transmitting the number of treatment credits purchased to the microcontroller of the neurostimulator unit.

Abstract: An improved embodiment of an external device for an implantable medical device system is described herein, where the external device has both circuitry for charging the implantable medical device and circuitry for telemetering data to and from the medical implant contained within a single housing. The external device in one embodiment includes orthogonal radiators in which both the radiators are used for data transfer, and in which at least one of the radiators is used for power transfer. Having charging and data telemetry circuitry fully integrated within a single external device conveniences both patient and clinician.

Abstract: The disclosure is directed to programming implantable stimulators to deliver stimulation energy via one or more implantable leads having complex electrode array geometries. The disclosure also contemplates guided programming to select electrode combinations and parameter values to support efficacy. The techniques may be applied to a programming interface associated with a clinician programmer, a patient programmer, or both. A user interface permits a user to view electrodes from different perspectives relative to the lead. For example, the user interface provides a side view of a lead and a cross-sectional view of the lead. The user interface may include an axial control medium to select and/or view electrodes at different axial positions along the length of a lead, and a rotational control medium to select and/or view electrodes at different angular positions around a circumference of the lead.

Abstract: A method comprises: selecting a plurality of electrodes of one or more stimulation leads, the selected plurality of electrodes defining a two-dimensional region; determining a calibration value for stimulation points defined by the plurality of electrodes; selecting a stimulation point within a boundary formed by the two-dimensional region; identifying points on the boundary that are axially displaced relative to the selected stimulation point; automatically calculating boundary calibration values for identified points, each boundary calibration value being calculated as a linear interpolation of calibration values of a pair of stimulation points determined for the plurality of electrodes; automatically assigning a calibration value to the selected stimulation point that is a summation of the calculated boundary calibration values; and using the automatically assigned calibration value for the stimulation point to control an amplitude of stimulation pulses applied to the patient.

Abstract: The invention is directed to structure and methods for coordinating the operation of an implantable medical device (IMD) with magnetic resonance imaging (MRI) techniques. For example the IMD can be made to activate a blanking period during the time when the electromagnetic radiation bursts occur. Blanking an IMD at times when MRI electromagnetic radiation bursts occur can prevent an undesirable action or incorrect sensing by the IMD while under the influence of the electromagnetic radiation bursts.

Abstract: A method embodiment comprises generating a neural stimulation signal for a neural stimulation therapy. The signal is generated during a duty cycle of a stimulation period to provide the neural stimulation therapy with an intensity at a therapy level for a portion of the duty cycle. In various embodiments, a ramp up protocol is implemented to begin the duty cycle, a ramp down protocol is implemented to end the duty cycle, or both the ramp up protocol and the ramp down protocol are implemented. The ramp up protocol includes ramping up the intensity from a non-zero first subthreshold level for the neural stimulation therapy at the beginning of the duty cycle to the therapy level. The ramp down protocol includes ramping down the intensity from the therapy intensity level to a non-zero second subthreshold level for the neural stimulation therapy at the end of the duty cycle.

Abstract: An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A system and method for securely exchanging sensitive information with an implantable medical device is presented. A crypto key stored on an implantable medical device is retrieved by a programmer via a secure short range interface. Sensitive information is encrypted as sensitive data using the crypto key. The encrypted data is stored on the implantable medical device.

Abstract: A system and method for providing a volume of activation (VOA) of a stimulation electrode leadwire may include a processor that calculates a VOA for each of a plurality of sets of parameter settings of the leadwire, stores in a database each of the calculated VOAs in association with the respective set of parameter settings for which it was calculated, performs a curve fitting on threshold values determined for a plurality of waveforms to obtain an equation, obtains a set of parameter settings of the leadwire for a stimulation, and determines a VOA for the obtained set of parameter settings based on the stored VOAs, for example, using the equation.

Abstract: A method of treating a patient and an external programmer for use with a neurostimulator. Electrical stimulation energy is serially conveyed into tissue of the patient via different combinations of electrodes implanted within the patient, thereby creating one or more clinical effects for each of the different electrode combinations. An influence of each of the different electrode combinations on the clinical effect(s) is determined. A graphical indication of the one or more clinical effects is generated based on the determined electrode combination influences. A graphical representation of the electrodes is displayed. The graphical indication of the clinical effect(s) is displayed adjacent the graphical electrode representation, such that a user can view an extent to which each of the different electrode combinations influences the clinical effect(s).

Abstract: The disclosure is directed to a user interface with a menu that facilitates stimulation therapy programming. The user interface displays a representation of the electrical leads implanted in the patient and at least one menu with icons that the user can use to adjust the stimulation therapy. The user may drag one or more field shapes from a field shape selection menu onto the desired location relative to the electrical leads. A manipulation tool menu may also allow the user to adjust the field shapes placed on the electrical leads, which represent the stimulation region. The programmer that includes the user interface then generates electrical stimulation parameter values for the stimulator to deliver stimulation according to the field shapes or field shape groups defined/located by the user. The field shapes may represent different types of stimulation representations, such as current density, activation functions, and neuron models.

Abstract: A system for programming a neurostimulation device coupled to one or more electrodes. The system comprises a user interface configured for allowing a user to select a set of stimulation parameters and to define a graphical shape representative of an anatomical region of interest. The system further comprises memory configured for storing the graphical shape in registration with an anatomical reference, and output circuitry configured for communicating with the neurostimulation device. The system further comprises a controller configured for recalling the registered graphical shape and anatomical reference from the memory, generating display signals capable of prompting the user interface to concurrently display a representation of the electrode(s) relative to the recalled graphical shape and anatomical reference, and programming the neurostimulation device with the selected stimulation parameter set via the output circuitry.

Abstract: A neurostimulation system delivers neurostimulation to a patient using one or more primary parameters and one or more secondary parameters. The one or more primary parameters are controlled for maintaining efficacy of the neurostimulation. The one or more secondary parameters are adjusted for preventing the patient from developing neural accommodation. In various embodiments, values for the one or more secondary parameters are varied during the delivery of the neurostimulation for prevention of neural accommodation that may result from a constant or periodic pattern of stimulation pulses.

Abstract: A system for programming a plurality of different models, or generations, of neurostimulation devices includes a plurality of plug in software drivers stored on a hard drive of the system, wherein the plurality of plug-in software drivers are respectively configured for facilitating communication between the plurality of different models of neurostimulation devices and the system processor via a transceiver. In a method of programming a plurality of different models of neurostimulation devices, the system processor dynamically identifies the model of an interrogated neurostimulator and determines which plug-in software driver to use for programming the interrogated neurostimulator. The plug-in software drivers are cached into memory upon start-up of the system.

Abstract: A patient device (PD) for wireless data communication with an implant. The PD can be at least in an unpaired state or a paired state. In the paired state the PD is paired to a specific implant specified by an implant's identification code (IIC). The IIC is stored in PD memory. Automatic pairing of the PD to a specific implant is performed upon receiving an incoming data packet containing an IIC when the PD is in its unpaired state with no valid IIC stored in memory. Thus, the PD is tentatively paired to an implant identified by the IIC contained in the incoming data packet by storing the IIC in the memory. Tentative pairing is cancelled if no further communication occurs within a predetermined period of time. A soft paired state is entered if further data communication does occur.

Abstract: A method of operating a neurostimulation device comprises varying a first stimulation parameter under user control while fixing a second stimulation parameter, generating a plurality of stimulation parameter sets from the varied first stimulation parameter and the fixed second stimulation parameter, outputting a pulsed electrical waveform from the neurostimulation device between electrodes in accordance with the stimulation parameter sets, such that a therapeutic effect is achieved while allowing neural tissue to undergo neurological accommodation, changing the second stimulation parameter, varying the first stimulation parameter under user control while fixing the second changed stimulation parameter, generating another plurality of stimulation parameter sets from the varied first stimulation parameter and the fixed changed second stimulation parameter, and outputting the pulsed electrical waveform from the neurostimulation device between the electrodes in accordance with the other stimulation parameter sets

Abstract: The disclosure describes an implantable stimulation system that guides programming with a therapeutic tree. All possible stimulation parameters are arranged on the therapeutic tree, with each level of the therapeutic tree containing a different stimulation parameter type. Each level includes nodes that are connected to nodes of adjacent levels. A program path is created by moving through nodes of lower levels. The stimulation parameter types are arranged so that coarse adjustments occur at higher levels of the tree and fine adjustments occur at lower levels of the tree. The nodes of the program path define the stimulation parameters of the delivered stimulation therapy. The user may provide information such as efficacy input and/or medication dosage information to the system for identifying the most efficacious program path in treating pain of the patient. Additionally or alternatively, efficacy feedback may be received from physiological parameter sensors.

Abstract: An implantable medical device (IMD) including an input interface that operates to receive an external input and a stimulation mode controller coupled to the input interface. The stimulation mode controller operates to temporarily interrupt a normal stimulation mode of the IMD in response to the external input. The IMD also includes an alternative stimulation selection module coupled to the stimulation mode controller, the alternative stimulation selection module operating to determine whether to implement an alternative mode of electrical signal therapy based on the external input and a threshold. The alternative mode differs in at least one stimulation parameter from the normal stimulation mode. The stimulation mode controller further operates to implement the alternative mode of the electrical signal therapy based on the determination of the alternative stimulation selection module.

Abstract: Embodiments of the present invention generally relate to neurostimulation systems, methods for use with neurostimulation systems, and devices (e.g., programmers) of neurostimulation systems. Such a neurostimulation system can include, e.g., a neurostimulator, a programmer configured to communicate with and program the neurostimulator, and one or more leads connected to the neurostimulator, wherein each lead includes one or more electrodes. A method, according to an embodiment of the present invention, is for enabling efficient identification of one or more preferred sets of neurostimulation parameters from among numerous possible sets of neurostimulation parameters, wherein each set of neurostimulation parameters specifies a lead, an electrode configuration for the specified lead, and one or more pulse parameters (e.g., a pulse amplitude value, a pulse width value and/or a pulse frequency value).

Abstract: A method for identifying, suppressing, and reversing epileptogenesis, which is considered to be a learned response due to brain plasticity. The method includes identifying three epileptogenic conditions, neuronal hyperexcitability, spatial overconnectivity, and temporal overconnectivity. A treatment that accounts for each of these conditions is then be administered to the subject to reverse, or “unlearn,” epilepsy.

Abstract: A biostimulator system comprises one or more implantable devices and an external programmer configured for communicating with the implantable device or devices via bidirectional communication pathways comprising a receiving pathway that decodes information encoded on stimulation pulses generated by ones of the implantable device or devices and conducted through body tissue to the external programmer.

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

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: Exemplary lead assemblies include a lead body having a plurality of conductor wires embedded therein, a plurality of electrode contacts at least partially disposed on an outer surface of the lead body, and a plurality of switching networks each configured to control an operation of one or more of the plurality of electrode contacts.

Abstract: A connector for an implantable medical device includes a lumen extending from a port defined along a length of a connector housing. Axially-spaced-apart connector couplers are disposed along the lumen and are configured to couple to a proximal end of an inserted lead or lead extension. Each of the connector couplers includes a plurality of circumferentially-spaced-apart coupling members and at least one elastic member. The plurality of circumferentially-spaced-apart coupling members each have inner surfaces and outer surfaces. The inner surfaces of the coupling members are configured and arranged to couple to the proximal end of the lead or lead extension when the proximal end of the lead or lead extension is inserted into the lumen. The at least one elastic member couples the coupling members to one another such that a distance between the coupling members is expandable.

Abstract: A system and method for establishing communication among a control device and an implantable medical device. The implantable medical device transmits to the control device identification information including a unique identification number associated with the implantable medical device and/or a current version of application software currently being utilized by the implantable medical device. Based on the extracted identification information, the control device correlates thereto a version of the application software from among the multiple versions of application software associated with the control device that is compatible with the recognized version of the application software currently being utilized by the implantable medical device.

Abstract: An external processor device is described for an implantable prosthetic system. An external processor housing has a generally planar skin contacting surface and a central axis perpendicular to the skin contacting surface. A signal processor is located within the processor housing for developing an implant data signal. The processor housing also contains a transmitter coil for coupling the implant data signal across the skin to the implantable prosthetic system. A battery compartment is also located within the processor housing in an annular region around the central axis for containing a battery arrangement to provide electrical power to the signal processor and the transmitter coil.

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: Wet-tantalum capacitors used in a medical device are charged to and maintained at a maintenance voltage between full energy charges so that deformation in the wet-tantalum capacitor is substantially inhibited.

Abstract: Systems and methods for efficiently transmitting power using a high frequency (e.g., RF) telemetry transmitter are provided. The telemetry transmitter may include a fixed clock source (which may provide a fixed clock signal), telemetry phase shift circuitry (which may include switching circuitry and phase shifting circuitry), and a push-pull network. The telemetry phase shift circuitry generates a phase shifted clock signal that is phase shifted with respect to the fixed clock signal. The fixed and phase shifted clock signals may drive the switching circuitry to produce a high frequency signal that is passed through the push-pull network. The power or magnitude of the high frequency signal is based on the phase delay between the fixed clock signal and the phase shifted clock signal.

Abstract: Exemplary techniques for recording a context for sensed biological data are described. One technique senses biological data from a patient and records supporting data with the sensed biological data.

Abstract: A system for a neurostimulator coupled to electrodes.