Medtronic, Inc.

Duane L Bourget

Keith Alan Miesel

Timothy J Denison

David A Dinsmoor

Erik R Scott

John E Kast

Randy S Roles

Xuan K Wei

Scott R Stanslaski

Eric J Panken

Jon P Davis

Rajeev Madhukar Sahasrabudhe

Richard T Stone

Craig L Schmidt

Eric H Bonde

Christian S Nielsen

Phillip C Falkner

Christopher L Pulliam

Gabriela C Molnar

Gordon Orvis Munns

Thomas P Miltich

Brad Conrad Tischendorf

Bernard Q Li

Chris J Paidosh

Joseph J Viavattine

Dennis M Skelton

Gregory F Molnar

William Frederick Kaemmerer

Jerome T Hartlaub

Shyam Gokaldas

Steven M Goetz

Jonathon E Giftakis

David L Carlson

Timothy R Abraham

Joel A Anderson

Todd V Smith

Forrest C M Pape

Stephen J Roddy

Kristin N Hageman

Hank Bink

Jiashu Li

Benjamin P Isaacson

Michael Jay Ebert

Reginald D Robinson

Prabhakar A Tamirisa

Markus W Reiterer

Shawn C Kelley

Anthony M Chasensky

David E Linde

Jeffrey Herron

Joseph J Nolan

James Zimmerman

Thomas Adamski

Mandla Thokozani Shongwe

Dennis J Bourget

Nicholas D Buse

Thaddeus S Brink

Robert S Raike

Timothy Denison

Rene A Molina

Abbey Beuning Holt Becker

Thomas L Chouinard

Robert Devine

Timmothy S Carlson

Caleb C Zarns

Laura Ann Skarie

James A Zimmerman

Systems, devices, methods, and techniques are described for using evoked compound action potential (ECAP) signals to monitor lead position and/or detect lead migration. An example system includes sensing circuitry configured to sense an ECAP signal, and processing circuitry. The processing circuitry controls the sensing circuitry to detect, after delivery of an electrical stimulation pulse, a current ECAP signal, and determines one or more characteristics of the current ECAP signal. The processing circuitry also compares the one or more characteristics of the current ECAP signal to corresponding one or more characteristics of a baseline ECAP signal, and determines, based on the comparison, a migration state of the electrodes delivering the electrical stimulation pulse. Additionally, the processing circuitry outputs, based on the migration state, an alert indicative of migration of the electrodes.

Implantable lead migration monitoring using ECAP

This disclosure is directed to devices, systems, and techniques for controlling electrical stimulation. In some examples, a system includes a user interface and processing circuitry. The processing circuitry is configured to output, for display by the user interface, a message requesting the patient perform a set of actions, receive, from the user interface, user input indicative of a patient response associated with the set of actions, and determine, based on the user input, one or more adjustments to a control policy which controls electrical stimulation delivered by a medical device based on a plurality of evoked compound action potentials (ECAPs) sensed by the medical device.

Control policy settings for electrical stimulation therapy

An example method includes determining, by an implantable medical device (IMD), an electrode of a plurality of electrodes of a lead to be used to deliver electrical stimulation to a patient at a particular time; selecting, by the IMD and based on the determined electrode, a set of electrodes of the plurality of electrodes; and sensing, by the IMD and via the selected set of electrodes, electrical signals of the patient at the particular time.

Dynamically optimized neural sensing

In one example, the disclosure describes a method comprising receiving, by processing circuitry, information indicative of one or more evoked compound action potential (ECAP) signals. The one or more ECAP signals are sensed by at least one electrode carried by a medical lead. The processing circuitry determining that at least one characteristic value of the one or more ECAP signals is outside of an expected range. Responsive to determining that the at least one characteristic value of the one or more ECAP signals is outside of the expected range, the processing circuitry performs a lead integrity test for the medical lead.

Lead integrity and closed-loop algorithm diagnostic

A medical device or system of medical devices can be configured to detect an indicator of a symptom in a patient; in response to detecting the indicator of the symptom in the patient, deliver to the patient a first stimulation therapy; and in response to determining that the indicator of the symptom has been present for more than a threshold amount of time after beginning to deliver the first stimulation therapy a second stimulation therapy different than the first stimulation therapy.

Multi-target adaptive neurostimulation therapy control

A neuromodulation therapy is delivered via at least one electrode implanted subcutaneously and superficially to a fascia layer superficial to a nerve of a patient. In one example, an implantable medical device is deployed along a superficial surface of a deep fascia tissue layer superficial to a nerve of a patient. Electrical stimulation energy is delivered to the nerve through the deep fascia tissue layer via implantable medical device electrodes.

Minimally invasive implantable neurostimulation system

A medical device system for delivering a neuromodulation therapy includes a delivery tool for deploying an implantable medical device at a neuromodulation therapy site. The implantable medical device includes a housing, an electronic circuit within the housing, and an electrical lead comprising a lead body extending between a proximal end coupled to the housing and a distal end extending away from the housing and at least one electrode carried by the lead body. The delivery tool includes a first cavity for receiving the housing and a second cavity for receiving the lead. The first cavity and the second cavity are in direct communication for receiving and deploying the housing and the lead coupled to the housing concomitantly as a single unit.

Techniques are disclosed for defining a homeostatic window for controlling delivery of electrical stimulation therapy to a patient. In one example, a method includes generating and delivering electrical stimulation therapy to tissue of a patient via electrodes. Further, the method includes adjusting a level of a parameter of the electrical stimulation therapy such that a signal of the patient is not less than a lower bound and not greater than an upper bound. The lower bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce one or more symptoms of a disease while the patient was receiving medication for reduction of the one or more symptoms. Further, the upper bound is determined to be the magnitude of the signal while receiving electrical stimulation therapy sufficient to reduce the one or more symptoms when the patient was not receiving the medication.

Adaptive deep brain stimulation using homeostatic window

A medical device may receive sensor data from sensing sources, and determine confidence levels for sensor data received from each of the plurality of sensing sources. Each of the confidence levels of the sensor data from each of the sensing sources is a measure of accuracy of the sensor data received from respective sensing sources. The medical device may also determine one or more therapy parameter values based on the determined confidence levels, and cause delivery of therapy based on the determined one or more therapy parameter values.

Closed-loop stimulation therapy in event of loss of sensor data

Devices, systems, and techniques are described for transitioning between different groups of electrical stimulation programs. For example, a system may control delivery of second electrical stimulation defined by one or more second programs of a second group of stimulation programs on a time-interleaved basis with first electrical stimulation defined by one or more first programs of the first group of stimulation programs. The system may change a first ratio of the one or more first programs used to define the first electrical stimulation to the one or more second programs used to define the second electrical stimulation delivered within a first period of time to a second ratio of the one or more first programs used to define the first electrical stimulation to the one or more second programs used to define the second electrical stimulation delivered within a second period of time.

Changing electrical stimulation

Growing community of inventors

Albertville, MN, United States of America

Duane L Bourget