Abstract: The present disclosure provides systems and methods for treating apnea by controlled delivery of a swallow stimulus to a subject in which apnea is detected. In the systems and method, burst electrical or mechanical stimulation to one or more swallow-related nerves and/or muscles can be timed for delivery between the expiratory phase of the respiration cycle, following detection of an apneic event in the subject.

Abstract: A lead anchor includes a core housing defining a cavity; a swivel anchor disposed in the cavity and having a tubular portion and a locking portion; at least two locking members; and at least two sleeves with a portion of each of the sleeves and each of the locking members disposed within the cavity at a periphery of the cavity. The tubular portion is adapted to receive an external tool to rotate the swivel anchor within the cavity. The lead anchor has an unlocked configuration, in which the swivel anchor can rotate within the cavity of the core housing without compressing the sleeves, and a locked configuration, in which opposing ends of the locking portion of the swivel anchor each lie between one of the sleeves and one of the locking members and compress the sleeves and any lead disposed within the sleeves to hold that lead in place.

Abstract: A lead assembly for providing electrical stimulation to a patient includes a penetrating electrode configured and arranged for stimulating patient tissue. The penetrating electrode has an outer surface and includes at least one sharpened tip configured and arranged to pierce patient tissue and anchor the lead assembly to the pierced patient tissue. An elongated, flexible tether has a first end and an opposing second end. The first end is coupled to the penetrating electrode. The second end is configured and arranged to couple to a pulse generator. An elongated conductor extends along the tether and is electrically coupled to the penetrating electrode.

Abstract: A neuromodulation system and method of providing therapy to a patient. A plurality of individual electrical pulse trains is generated at a respective plurality of individual pulse rates. The plurality of individual electrical pulse trains are concurrently respectively from a plurality of electrodes to a common electrode via tissue of the patient, thereby creating a combined electrical pulse train having an average pulse rate equal to or greater than 1 KHz.

Abstract: A therapy delivery element including a plurality of fibers braided to form an elongated braided structure with a lumen. At least one reinforcing structure is woven into the fibers of the braided structure. A portion of at least one reinforcing structure extends from the braided structure to form a fixation structure. A conductor assembly including a plurality of conductors is located in the lumen. An electrode assembly is located at a distal end of the conductor assembly. The electrode assembly includes a plurality of electrodes that are electrically coupled to the conductors. A connector assembly is located at a proximal end of the conductor assembly. The connector assembly includes a plurality of electrical contacts that are electrically coupled to the conductors. At least one of the braided structure or the reinforcing structure is attached to at least one of the electrode assembly or the connector assembly.

Abstract: A system including two neurostimulation leads can be used for stimulating a select region of a nerve within a nerve bundle. For example, two leads can be used to stimulate a select region of the vagus nerve located within a patient's carotid sheath. The first neurostimulation is positioned within the carotid sheath and the second neurostimulation lead is positioned external to the carotid sheath. Each of the first and second neurostimulation leads includes at least one electrode defining an electrode array about the select region of the nerve. The electrode array, and more particularly, the different possible electrode vector combinations provided by the first and second neurostimulation leads facilitate steering of stimulation current density fields as needed or desired between the electrodes to effectively and efficiently treat a particular medical, psychiatric, or neurological disorder.

Abstract: A multi-channel neurostimulation system comprises a plurality of electrical terminals configured for being respectively coupled to a plurality of electrodes, stimulation output circuitry including electrical source circuitry of the same polarity configured for generating a plurality of pulsed electrical waveforms in a plurality of timing channels, and control circuitry configured for instructing the stimulation output circuitry to serially couple the electrical source circuitry to different sets of the electrodes when pulses of the respective pulsed electrical waveforms do not temporally overlap each other, and for instructing the stimulation output circuitry to couple the electrical source circuitry to a union of the different electrode sets when pulses of the respective pulsed electrical waveforms temporally overlap each other.

Abstract: An apparatus and method are disclosed for providing efficient stimulation. As an example, a switched mode power supply can be configured to generate a dynamic compliance voltage based on a stimulus waveform that can be non-rectangular. An output stimulation signal can be supplied to one or more outputs based on the compliance voltage.

Abstract: A system for treatment of gait disorders includes an external device in the form of a pulse generator (4) with an integrated rechargeable battery and a device adapted to be implanted in the human body. The system features an external to the body placed antenna (3) for the inductive link between the external device and the implanted device. This antenna further incorporates an additional secondary coil (24), for inductively charging the battery in the pulse generator. The fixture on the antenna for mounting the antenna on the skin of the person is reused for being received in a charger fixture (20) on the charger, containing the primary coil (22) for the transfer of charging power.

Abstract: An array stimulator has a plurality of electrodes in an array, the electrodes forming a plurality of electrode pairs, and a signal generator for generating signals to the electrodes so as to generate electrical pulse in a patient to which the stimulator has been applied either transcutaneously or by implantation. Those electrical pulses form a composite pulse in the patient which stimulates the nervous system of the patient. The composite pulse has a duration between 4 ?s and 1500 ?s and a maximum voltage between 2V and 50V when the stimulator is implanted, and 15V to 500V when applied transcutaneously. The electrical pulses themselves are significantly shorter duration than the composite pulse, so they stimulate the nervous system of the patient much less than the composite pulse or not at all.

Abstract: An implantable device (10) is used to emit electrical stimulation signals to surrounding tissue by means of at least one stimulation electrode (17). The device (10) has a sensor unit (26), which generates a useful signal (D) in the form of analogue voltage pulses (73) from externally fed signals, and an output stage (28) which generates the stimulation signals (E) from the useful signal (D). The output stage (28) emits the stimulation signals (E) in, averaged over time, a substantially DC voltage free fashion to an external ground (29), which can be connected to the tissue (64).

Abstract: The present invention comprises a medical device having a baroreflex stimulator to generate a stimulation signal, the stimulation signal being adapted to stimulate a baroreflex, and a controller to communicate with the baroreflex stimulator and implement a baroreflex stimulus regimen to vary an intensity of the baroreflex stimulation provided by the stimulation signal to maintain stimulation efficacy.

Abstract: The invention relates to a method and apparatus for diagnosis of conductor anomalies, such as insulation failures, in an implantable medical device, such as an implantable cardioverter defibrillator (ICD), a pacemaker, or a neurostimulator. Insulation failures are detected and localized by identifying changes in electrical fields via surface (skin) potentials. Small variations in potential are detected along the course of the electrode near the site of insulation failure.

Abstract: A method for modulating nerve tissue in a body of a patient includes implanting a wireless stimulation device in proximity to a dorsal root ganglion or an exiting nerve root such that an electrode, circuitry and a receiving antenna are positioned completely within the body of the patient. An input signal containing electrical energy and waveform parameters is transmitted to the receiving antenna(s) from a control device located outside of the patient's body via radiative coupling. The circuitry within the stimulation device generates one or more electrical impulses and applies the electrical impulses to the dorsal root ganglion or the exiting nerve roots through the electrode.

Abstract: Neural stimulation is effected by a stimulus current pulse. The current pulse is initially of an amplitude to rapidly induce a desired electrode voltage, and is subsequently of reduced amplitude to control electrode voltage in a desired manner. This can effect a reduced peak electrode voltage while delivering a given amount of charge. Optimization of the current pulse may further involve parameterising an electrode current waveform as a sequence of piecewise constant steps, each step having substantially the same duration as all other steps and each step having a calculatable amplitude, and identifying electrode-tissue interface (ETI) parameters. For each step of the pulse, the respective step amplitude is then calculated using the identified ETI parameters to optimise the electrode voltage.

Abstract: Systems and methods for stimulation of neurological tissue generate stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide a lower average frequency.

Abstract: A method of treating an ailment suffered by a patient using one or more electrodes adjacent spinal column tissue of the patient, comprises delivering electrical modulation energy from the one or more electrodes to the spinal column tissue in accordance with a continuous bi-phasic waveform having a positive phase and a negative phase, thereby modulating the spinal column tissue to treat the ailment. An implantable electrical modulation system, comprises one or more electrical terminals configured for being coupled to one or more modulation leads, output modulation circuitry capable of outputting electrical modulation energy to the electrical terminal(s) in accordance with a continuous bi-phasic waveform, and control circuitry configured for modifying a shape of the continuous bi-phasic waveform, thereby changing the characteristics of the electrical modulation energy outputted to the electrode(s).

Abstract: An electrical stimulation device and non-invasive method for treating dysphagia and artificially promoting swallowing by simultaneous electrical stimulation of the pharyngeal and facial muscles. The device includes a plurality of electrodes selectively placed in electrical contact with pharyngeal and oral-facial regions of a patient and a series of electrical pulses in electrical contact with each of the plurality of electrodes with a generator. The generator includes a pulse rate modulator for generating electrical pulses having a frequency generally fixed at 80 hertz, a pulse width modulator for generating a series of electrical pulses each at a duration fixed at 300 microseconds, and a governor for regulating the electrical pulses such that at least one of current does not to exceed 4.4 milliamps RMS or power does not to exceed 9.6 MW RMS. The electrical pulses selectively stimulate muscles located proximate to the electrodes to close the mouth and initiate swallowing.

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.

Abstract: The implantable medical device includes high-voltage components (such as defibrillation shock generation components) operative to generate high-voltage pulses for delivery to tissues of the patient while using the case or housing of the device as a stimulation electrode. The device also includes low-voltage Medical Implant Communication Service (MICS) or Medical Device Radiocommunications Service (MedRadio) components operative to generate low-power signals for communicating with an external device via radio frequencies while using the case as part of an antenna. A conductive noise shield is mounted within the case of the device and interposed between the high-voltage components and the case, with the shield configured to attenuate electrical interference between the high-voltage components and the case to facilitate radio-frequency communication between the low-voltage MICS/MedRadio components and the external device, which use the case as part of the antenna.

Abstract: Embodiments provided herein generally relate to electrical stimulation enhanced ultrasound. In some embodiments, a device for ultrasound imaging is provided and includes an ultrasound head and an electrical stimulator. Ultrasound images can be taken before, during, and/or after electrical stimulation to determine if the ultrasound characteristics of a tissue have changed due to the electrical stimulation.

Abstract: The invention relates to a device for controlled modulation of physiological and pathological neuronal rhythmic activity in the brain by means of sensory stimulation, which is capable of diagnostically ascertaining functional disorders in the brain and of alleviating or eliminating the symptoms of a functional disruption. According to the invention, the device comprises a control unit (4), a stimulator (1) and at least one means for detecting brain activity, said means being connected to the control unit (1).

Abstract: Various implantable device embodiments may comprise a neural stimulator configured to deliver a neurostimulation therapy with stimulation ON times and stimulation OFF times where a dose of the neurostimulation therapy is provided by a number of neurostimulation pulses over a period of time. The neural stimulator may be configured to monitor the dose of the delivered neurostimulation therapy against dosing parameters. The neural stimulator may be configured to declare a fault if the monitored dose does not favorably compare to a desired dose for the neurostimulation therapy, or may be configured to record data for the monitored dose of the delivered neurostimulation therapy, or may be configured to both record data for the monitored dose of the delivered neurostimulation therapy and declare a fault if the monitored dose does not favorably compare to a desired dose for the neurostimulation therapy.

Abstract: Renal function may be modulated by an implantable device having one or more leads or catheters disposed near the kidney via the lymphatic system. In one embodiment, lymphatic drainage from the kidney is modulated to increase or decrease tubular reabsorption of salt and water. The renal function modulation therapy may be delivered in an open-loop or closed-loop fashion, with the latter dependent upon a physiological variable such as blood pressure or cardiac output.

Abstract: Disclosed herein is an implantable medical device including an antimicrobial layer. The antimicrobial layer may include a first distinct size of silver nanoparticles, a second distinct size of silver nanoparticles, and a third distinct size of silver nanoparticles. The antimicrobial layer extends over a surface of the implantable medical device, and, in some instances, the surface of the implantable medical device may serve as a substrate on which the antimicrobial layer is deposited.

Abstract: An apparatus and method for treating viral infections delivers electrical stimulation to the skin or mucosa of a patient. The electrical stimulation is applied as a series of electrical pulses having different electrical characteristics. The apparatus may include a housing having at least two electrodes supplied with both AC and DC voltage, and powered by a battery. The electrodes are designed so as to maximize contact with the patient.

Abstract: An implantable pulse generator includes a header, a can, a grouped array feedthru, and an inline array feedthru board. The feedthru includes a header side, a can side and a grouped array of feedthru wires extending through the feedthru. A first end of each feedthru wire is electrically coupled to a lead connector block. The inline array feedthru board includes a grouped array of first electrical contact holes and an inline array of conductor wires. The grouped array of first electrical contact holes receives therein second ends of the feedthru wires. The inline array of conductor wires projects from a side of the board opposite the feedthru. Each first electrical contact hole is in electrical communication with a respective conductor wire. Each conductor wire is in electrical contact with at least a portion of an electrical connection region of an electronic substrate housed within the can.

Abstract: Systems and methods for stimulation of neurological tissue and generation stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. The features of the stimulation trains may be selected and arranged algorithmically to by clinical trial. These stimulation trains are generated to target a specific neurological disorder, by arranging sets of features which reduce symptoms of that neurological disorder into a pattern which is effective at reducing those symptoms while maintaining or reducing power consumption versus regular stimulation signals. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide increased efficacy and/or a lower than average frequency.

Abstract: A titanium alloy metal sheet is provided and heated to a superplastic forming temperature. A die has a plurality of housing forming areas each corresponding to one of the medical device housing portions. The heated titanium alloy metal sheet is forced onto the die and over each one of the plurality of housing forming areas, thereby superplastically forming a workpiece comprising a plurality of integrally formed implantable medical device housing portions.

Abstract: Systems and techniques for improving the fixation of implantable pulse generators. In one aspect, a device includes an implantable pulse generator that comprises electrical circuitry configured to generate an electrical pulse and a biocompatible casing that houses the electrical circuitry and on which a collection of electrodes and a collection of fixation elements are mounted. The electrodes are in electrical contact with the electrical circuitry and the fixation elements increase the surface area of the biocompatible casing to reduce the likelihood that the biocompatible casing shifts after implantation.

Abstract: The invention relates to a method for neuromodulation, in which an electrode comprising a compressible and expandable grid structure with cells formed from grid webs is arranged within a blood vessel, wherein the grid structure is expanded and, at least in expanded state, is exposed to electrical energy such that surrounding postganglionic parasympathetic nerve fibres of the sphenopalatine ganglion are electrically stimulated by the electrode.

Abstract: A header of an implantable medical pulse generator may include a lead connector end receiving receptacle for transmitting electrical pulses from the can to the lead through an electrically conductive setscrew contact in electrical communication with a terminal of the lead connector end. The setscrew contact includes a setscrew hole and a lead connector hole. The lead connector hole is aligned with the lead connector end receiving receptacle, and the setscrew hole includes a setscrew threadably received therein. Inner circumferential surfaces of the setscrew hole and lead connector hole are generally tangentially to each other such that a window is created by the overlap of the inner circumferential surfaces.

Abstract: A stimulation system and method for treating to a human subject having spasmodic dysphonia includes a sensing electrode configured to detect voice activity of a vocalizing muscle of the subject and to generate a first signal, and a processor configured to receive the first signal from the sensing electrode and to generate at least one stimulation parameter based on the first signal. The system further includes a mechanical actuator configured to receive the stimulation parameter from the processor and to activate a glottic closure reflex of the subject in response to the stimulation parameter and a stimulating electrode configured to receive the stimulation parameter from the processor and stimulate the recurrent laryngeal nerve or the vagus nerve of the subject based on the stimulation parameter.

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: A stimulation system and method for providing training therapy to a human subject having a weakened voice includes an activating switch configured to generate a first signal, and a processor configured to receive the first signal from the sensing electrode and to generate at least one stimulation parameter based on the first signal. The system further includes a stimulating electrode configured to receive the stimulation parameter from the processor and to activate a recurrent laryngeal nerve or vagus nerve of the subject in response to the stimulation parameter.

Abstract: Endovascular nerve monitoring devices and associated systems and methods are disclosed herein. A nerve monitoring system configured in accordance with a particular embodiment of the present technology can include a shaft having a proximal portion and a distal portion and a nerve monitoring assembly at the distal portion. The shaft is configured to locate the distal portion intravascularly at a treatment site. The nerve monitoring assembly can include a bipolar stimulation electrode array and a bipolar recording electrode array disposed distal to the bipolar stimulation electrode assembly.

Abstract: Systems and methods for stimulation of neurological tissue generate stimulation trains with temporal patterns of stimulation, in which the interval between electrical pulses (the inter-pulse intervals) changes or varies over time. Compared to conventional continuous, high rate pulse trains having regular (i.e., constant) inter-pulse intervals, the non-regular (i.e., not constant) pulse patterns or trains that embody features of the invention provide a lower average frequency.

Abstract: A medical device lead includes a conductor and one or more band stop filters each coupled to the conductor and including a conductive coil. The one or more band stop filters are configured to attenuate an MRI-induced signal on the conductor.

Abstract: Medical devices and contact assemblies for electrical connections between medical device components are disclosed herein. A medical device in accordance with a particular embodiment includes a patient implantable element having a receiving cavity and at least one contact assembly positioned in the receiving cavity. The contact assembly can include a housing having an annular shape with an inner surface defining at least in part an opening. The contact assembly can further include a contact disposed at least partially within the opening and having a plurality of leaf spring portions.

Abstract: In one embodiment, a pulse generator for generating electrical stimulation for delivery to a patient, comprises: a hermetically sealed housing containing pulse generating circuitry; a header coupled to the housing for receiving one or more stimulation leads, wherein feedthrough wires are provided to conduct electrical pulses from the pulse generating circuitry to the header; the header comprising a plurality of connectors for electrically connecting to each terminal of the one or more stimulation leads, wherein an inductive winding is disposed around or adjacent to each of the connector structures and is electrically connected between the respective connector structure and a corresponding feedthrough wire to limit MRI induced heating of a respective electrode of the one or more stimulation leads.

Abstract: Implementations of the present disclosure involve an implantable medical pulse generator for administering electrotherapy via an implantable medical lead having a lead connector end on a proximal end of the lead. The pulse generator may include a can and a header coupled to the can. The header may include a lead connector end receiving receptacle for transmitting electrical pulses from the can to the lead through one or more electrical spring contacts in electrical communication with one or more terminals of the lead connector end. The one or more spring contacts may include a triangular shaped metal spring within a housing that forms an electrical contact with the lead connector end when the one or more terminals of the lead connector end is inserted into the header. Alternatively, the metal spring may take other shapes, such as, for example, circular, elliptical, or rectangular.

Abstract: Implementations of the present disclosure involve an implantable medical pulse generator for administering electrotherapy via an implantable medical lead having a lead connector end on a proximal end of the lead. The pulse generator may include a can and a header coupled to the can. The header may include a lead connector end receiving receptacle for transmitting electrical pulses from the can to the lead through one or more electrical spring contacts in electrical communication with one or more terminals of the lead connector end. The one or more spring contacts may include a triangular shaped metal spring within a housing that forms an electrical contact with the lead connector end when the one or more terminals of the lead connector end is inserted into the header. Alternatively, the metal spring may take other shapes, such as, for example, circular, elliptical, or rectangular.

Abstract: This is a neurostimulator that is configured to treat epilepsy and other neurological disorders using certain stimulation strategies, particularly changing various pulse parameters, during the imposition of a burst of those pulses. The invention includes the processes embodying those stimulation strategies.

Abstract: The invention relates to a method for medical treatment of a mammal, preferably a human, by applying pulsed radiofrequency (PRF) stimulation intravascularly. More particularly, said method has as effect that it boosts the immune system and/or that it relieves pain. In a preferred embodiment, the disease or condition to be treated is caused or accompanied by immunodeficiency, more preferably the disease or condition is selected from the group of cancer, infectious diseases, immunosuppression or otherwise caused immunodeficiencies. Also auto- immune diseases and conditions associated with allostatic load are preferred for treatment with the method of the invention. In an also preferred embodiment, the PRF stimulation is applied together with vaccination.

Abstract: A therapeutic micro-current delivery device includes a first electrode in electrical contact with a user at a first user location, a second electrode in electrical contact with the user at a second user location, a power source operable to provide a first voltage potential at the first electrode and a second voltage potential at the second electrode, and a micro-current control circuit in electrical communication with the first electrode, second electrode and power source. Electrical contact of the first electrode at the first user location and electrical contact of the second electrode at the second user location completes an electrical circuit. The micro-current control circuit generates a micro-current Iramped through a user between the first location and the second location that increases from a start current Istart to an end current Iend over a rise time trise. Oral care devices and micro-current control methods are also disclosed.

Abstract: Transcutaneous electrical and magnetic nerve stimulation devices are disclosed, along with methods of averting imminent medical attacks using energy that is delivered noninvasively by the devices. The attacks comprise asthma attack, epileptic seizure, attacks of migraine headache, transient ischemic attack or stroke, onset of atrial fibrillation, myocardial infarction, onset of ventricular fibrillation or tachycardia, panic attack, and attacks of acute depression. The imminence of an attack is forecasted using grey-box or black-box models as used in control theory. In preferred embodiments of the disclosed methods, a vagus nerve in the neck of a patient is stimulated noninvasively to avert the attack.

Abstract: Disclosed herein is an implantable pulse generator. The implantable pulse generator may include a header, a can and a feedthru. The header may include a lead connector block electrically coupled to a first conductor. The can may be coupled to the header and include a wall and an electronic component electrically coupled to a second conductor and housed within the wall. The feedthru may be mounted in the wall and include a header side with a first electrically conductive tab and a can side with a second electrically conductive tab electrically coupled to the first tab. The first tab is electrically coupled to the first conductor and the second tab is electrically coupled to the second conductor.

Abstract: A biomedical conductor assembly adapted for at least partial insertion in a living body. The conductor assembly includes a plurality of the first electrical conductors each covered with an insulator and helically wound in a first direction to form an inner coil with a lumen. A plurality of second electrical conductors each including a plurality of un-insulated wires twisted in a ropelike configuration around a central axis to form a plurality of cables. Each cable is covered with an insulator and helically wound in a second opposite direction forming an outer coil in direct physical contact with the inner coil. The inner and outer coils are covered by an insulator. A method of making the conductor assembly and implanting a neurostimulation system is also disclosed.

Abstract: A lead identification system for tracking a plurality of neurostimulation leads during implantation in a patient, and a method of using the same. The lead identification system includes a plurality of lead indicators each adapted to attach to one of a plurality of epidural needles to identify the leads. At least one clip adapted to releasably attach to proximal ends of the leads is provided with corresponding lead indicators. The trial cable for conducting trial stimulation includes connectors with corresponding lead indicators. A plurality of lead indicator stylets are provided for insertion into lumens at the proximal ends of the leads. The pulse generator also has connectors with corresponding lead indicators. The various lead indicators permit a surgeon to track a particular lead to the corresponding connectors on the pulse generator.

Abstract: A method and neurostimulation system for providing therapy to a patient is provided. A plurality of electrodes is placed adjacent to tissue of the patient. A plurality of first electrical pulses is delivered to a first set of the electrodes, at least a second electrical pulse is delivered to a second set of the electrodes during the deliverance of each of the first electrical pulses, and at least a third electrical pulse is delivered to a third set of the electrodes during the deliverance of each of the first electrical pulses. The first electrical pulses have a first polarity, and each of the second electrical pulse(s) and third electrical pulses(s) has a second a second polarity opposite to the first polarity. The second and third electrical pulses are temporarily offset from each other.