Medtronic, Inc.

Boston Scientific Neuromodulation Corporation

Advanced Bionics Corporation

David K Peterson

Carla Mann Woods

Paul Milton Meadows

Joey Y Chen

David H Payne

Walter H Olson

Michael R Hill

Kathleen A Prieve

Gust H Bardy

Kerry A Bradley

James R Thacker

David E Francischelli

Johann J Neisz

Martin A Rossing

Robert T Taepke

Gary L Berg

Robert A Neumann

Ren Zhou

John Hammargren

Holly A Segel

Susan E Ford

Margaret E Theriot

William A Graham

Jordi Parramon

Goran Nils Marnfeldt

Eduardo N Warman

Rahul Mehra

Koen J Weijand

John G Keimel

Luc Roland Mongeon

Pierre Andre Grandjean

Timothy W Holleman

Thomas L Jirak

Michael John Link

Girard B Borgerding

Kendra K Gealow

Clare E Padgett

Thomas Kiekhafer

Fred Lindemans

Gerald P Borgerding

A programming system for selecting an electrode configuration for use in a medical electrical stimulator coupled to an electrode array. A programmer is configured for providing a set of electrode configurations for the electrode array, automatically testing a first portion of the set of electrode configurations in a first order, allowing the selection of one or more of the tested electrode configurations, determining whether a suitable number of electrode configurations from among the first portion have been selected within a predefined interval, and automatically testing a second portion of the set of electrode configurations in a second order if the suitable number of electrode configurations from among the first portion are not selected within the predefined interval. The programmer may further allow the selection of the tested electrode configurations, and adjusting parameters during the testing, wherein the adjusting is controllably shared in parallel between a clinician and a patient.

Method for programming implantabale device

Circuitry for generating a compliance voltage (V+) for the current sources and/or sinks in an implantable stimulator device is disclosed. The improved compliance voltage generation circuitry adjusts V+ to an optimal value in real time, even during the provision of a stimulation current. The circuitry uses amplifiers to measure the voltage drop across an active PDACs (current sources) and/or NDAC (current sinks) The measured voltages are input to a V+ regulator, which compares the measured voltage drops across the DACs to optimal values, and which feeds an optimized value for V+ back to the DACs in real time to keep the voltage drop(s) at those optimal levels during the stimulation current for efficient DAC operation.

Real time compliance voltage generation for an implantable stimulator

Methods for selecting Spinal Cord Stimulation (SCS), or other medical electrical stimulator, electrode configurations from a set of electrode configurations are provided. Each electrode configuration represents a polarity or a polarity percentage of the electrodes of an electrode array. The selected electrode configurations may be used in a medical electrical stimulator. Such methods of selecting electrode configurations results in a more efficient programming and use of the stimulation system.

Method for programming implantable device

Implantable pulse generators and spinal cord stimulation (SCS) systems are provided. The implantable pulse generator comprises telemetry circuitry configured for wirelessly receiving programming signals from an external programmer, and a plurality of bi-directional current sources configured for being respectively coupled to a plurality of electrodes. The implantable pulse generator further comprises control circuitry configured for directing the bi-directional current sources to output current pulses of a selected amplitude and polarity to the electrodes in accordance with the programming signals. The SCS system may comprise a plurality of electrodes, an external programmer configured for transmitting programming signals, and the afore-described implantable pulse generator as described above. In one embodiment, the SCS system further comprises one or more stimulation leads carrying the electrodes, in which case, the implantable pulse generator may further include a connector removably mated to the stimulation lead(s).

Rechargeable spinal cord stimulator system

A spinal cord stimulation (SCS) system includes multiple electrodes, multiple, independently programmable, stimulation channels within an implantable pulse generator (IPG) which channels can provide concurrent, but unique stimulation fields, permitting virtual electrodes to be realized. The SCS system includes a replenishable power source (e.g., rechargeable battery), that may be recharged using transcutaneous power transmissions between antenna coil pairs. An external charger unit, having its own rechargeable battery can be used to charge the IPG replenishable power source. A real-time clock can provide an auto-run schedule for daily stimulation. An included bi-directional telemetry link in the system informs the patient or clinician the status of the system, including the state of charge of the IPG battery. Other processing circuitry in the IPG allows electrode impedance measurements to be made. Further circuitry in the external battery charger can provide alignment detection for the coil pairs.

Rechargeable spinal cord stimulation system

An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.

Apparatus for treating atrial tachyarrhythmias with synchronized shocks

A cardiac stimulator and a method of its use. The stimulator includes a lead system carrying a stimulation electrodes adapted to be located at multiple sites adjacent tissue of a patient's heart and is provided with stimulation pulse generators coupled to deliver stimulation pulses to the stimulation electrodes. The stimulator further includes depolarization sensors responsive to depolarizations of cardiac tissues at the tissue sites and, responsive to sensed depolarizations and stimulation pulses delivered to said sites by said stimulation electrodes determines exitable gaps of tissue at the sites. The stimulator calculates stimulus pulse delivery times at variable delivery times within the determined exitable gaps at the tissue sites to cause convergence of depolarization cycles at the tissue sites over a series of delivered stimulation pulses and delivers stimulation pulses to the stimulation electrodes at the calculated variable delivery times.

Method and apparatus for treatment of fibrillation

An implantable cardiac pacemaker and a method of its operation. The pacemaker delivers pacing pulses to a first chamber of a patient's heart and senses depolarizations of a second chamber of the patient's heart. The amplifier for sensing depolarizations of the second chamber of the patient's heart defines a base sensing threshold and, responsive to delivery of a pacing pulse to the first chamber of the patient's heart for defines an increased sensing threshold greater than the base sensing threshold. The increased sensing threshold persists for a defined period of time following delivery of a pacing pulse to the first chamber of the patient's heart and thereafter gradually decreases from the increased sensing threshold to the base sensing threshold.

Implantable device with automatic sensing adjustment

An implantable anti-arrhythmia device such as a defibrillator or anti-tachycardia pacemaker with an associated patient activator. The arrhythmia detection function is divided between the patient and the implanted device, rather than merely providing patient activation or a patient override. The implantable device is provided with a tachyarrhythmia recognition mechanism, which operates essentially continuously, and which, upon meeting a first set of criteria, will trigger delivery of an anti-arrhythmia therapy such as pacing, cardioversion or defibrillation. The patient is provided with an activator which informs the implanted device that the patient believes that anti-arrhythmia therapy is necessary. In response to receipt of the activation signal, the implanted device defines a time interval thereafter during which a second, less stringent set of arrhythmia detection criteria must be met, in response to which the device will deliver a cardioversion or defibrillation pulse.

Method and apparatus for diagnosis and treatment of arrhythmias

A pacemaker provided with a mode switching feature adapted to stabilize ventricular heart rate during atrial fibrillation. In a preferred embodiment of the invention, the device nominally operates in an atrial synchronized pacing mode such as DDD, DDDR, VDD or VDDR. In response to detection of atrial rhythm characteristics consistent with atrial fibrillation, the device switches into a non-atrial synchronized, ventricular rate stabilization pacing mode with the base ventricular pacing rate modulated on a beat by beat basis based upon preceding intrinsic or paced ventricular heartbeat intervals to adjust the pacing interval towards a desired preset rate stabilization target pacing interval which is typically less than the programmed base pacing interval of the device. While the ventricular rate stabilization mode is in effect, the current pacing interval is set equal to the preceding intrinsic or paced interval, with an increment if the preceding interval is less than the desired or target pacing interval, as typically will be the case, or with a decrement if the preceding interval is greater than the desired pacing interval. In a preferred embodiment of the invention, the device paces both the atria and ventricles in a DDI rate stabilization pacing mode with the ventricular pacing interval being modulated.

An implantable pacemaker employing an arrhythmia prevention pacing modality particularly optimized for inclusion in dual chamber pacemakers and anti-arrhythmia devices which include dual chamber pacemakers. When the pacing mode is in effect, the device alters timing of scheduled atrial and/or ventricular pacing pulses in response to depolarizations sensed during the refractory periods and to ventricular depolarizations sensed outside of the pacemaker's A-V escape intervals. The arrhythmia prevention pacing mode is activated and deactivated in conjunction with the operation of arrhythmia detection features which may also be employed by the device to trigger delivery of anti-arrhythmia therapies.

Apparatus for diagnosis and treatment of arrhythmias

A cardiac assist device having muscle augmentation after a confirmed arrhythmia. In particular the present invention operates, in a first embodiment, to sense a cardiac event, next it determines whether the cardiac event is a cardiac arrhythmia, if the event is not a cardiac arrhythmia the devices delivers stimulation to a skeletal muscle grafted about a heart, but if the event is a cardiac arrhythmia the device inhibits delivery of skeletal muscle stimulation and once the arrhythmia is confirmed, then delivers therapeutic stimulation to the heart. In a second embodiment the present invention operates to re-initiate skeletal muscle stimulation once the arrhythmia is confirmed but prior to the delivery of the therapeutic stimulation to the heart.

Cardiac assist device having muscle augementation after confirmed

Growing community of inventors

Circle Pines, MN, United States of America

David K Peterson