Medtronic, Inc.

Graco Minnesota Inc.

Jeffrey T Keacher

Steven M Goetz

Andrew H Houchins

Gary William King

Kenneth Timothy Heruth

Roy L Testerman

Nathan Andrew Torgerson

Joseph J Nolan

Michael Thomas Lee

Jordan J Greenberg

Theodore J Stone

Donald R Johnson

Wende L Dewing

John Rondoni

Jon P Davis

Touby Austin Drew

Rajeev Madhukar Sahasrabudhe

Mark S Lent

Paul W Wacnik

Gabriela C Miyazawa

Shyam Gokaldas

Earle Timothy Roberts

Dennis M Skelton

Todd V Smith

John W Forsberg

Alex C Toy

Erik G Widman

Kelly L Shanks

Giselle Suraya Figueiredo

Gabriela C Miyazawa Molnar

Peripheral nerve field stimulation (PNFS) may be controlled based on detected physiological effects of the PNFS, which may be an efferent response to the PNFS. In some examples, a closed-loop therapy system may include a sensing module that senses a physiological parameter of the patient, which may be indicative of the patient's response to the PNFS. Based on a signal generated by the sensing module, the PNFS may be activated, deactivated or modified. Example physiological parameters of the patient include heart rate, respiratory rate, electrodermal activity, muscle activity, blood flow rate, sweat gland activity, pilomotor reflex, or thermal activity of the patient's body. In some examples, a patient pain state may be detected based on a signal generated by the sensing module, and therapy may be controlled based on the detection of the pain state.

Peripheral nerve field stimulation control

A system includes a pump controller, a user device, and a server. The pump controller transmits identity information via a first communication connection with the pump controller. The server validates the identity information in response to determining that characteristics of the identity information satisfy one or more predetermined validity criteria that are different than the identity information. The pump controller establishes a second communication connection with the server using authentication credentials generated by the server and transmitted to the pump controller in response to validating the identity information. The server transmits a unique activation code to the pump controller via the second connection. The pump controller displays the activation code. A user device associated with a user account transmits the activation code to the server. The server authorizes remote communications with the pump controller via the user account in response to determining that the activation request includes the activation code.

Remote pump monitoring and control

The disclosure provides techniques for parameter-directed shifting of electrical stimulation electrode combinations. An external programmer permits a user to shift electrode combinations, e.g., along the length of a lead or leads. The external programmer accepts shift input and causes an electrical stimulator to shift electrode combinations as indicated by the input. Different sets of electrodes may have different electrode counts. For example, an array of electrodes carried by one lead may have a greater number of electrodes than an array of electrodes carried on another lead. The disclosure provides techniques for shifting electrode combinations among leads with different electrode counts. For example, an external programmer may execute shifts in a series of shift operations, where the number of shift operations along the length of a lead having a greater electrode count is greater than the number of shift steps along the length of a lead having a lesser electrode count.

Shifting of electrical stimulation electrode combinations among differently sized electrode arrays

A therapy program for peripheral nerve field stimulation (PNFS) may be selected based on user input indicating a desired therapeutic effect for a user-specified region in which a patient feels pain. In other examples, PNFS may be programmed based on input from a user selecting at least one region from among a plurality of regions in which the patient experiences pain. In addition, the PNFS may be programmed based on user input defining an aspect of PNFS for the selected region, such as a relative intensity of PNFS delivered to at least two selected regions, a balance of PNFS between at least two regions, a desired shift in PNFS from a first region to a second region, or an extent to which a first stimulation field within a first region overlaps with a second stimulation field in a second region.

Programming techniques for peripheral nerve field stimulation

Peripheral nerve field stimulation (PNFS) delivered by medical device to a patient may be programmed by specifying one or more characteristics of a stimulation field generated by the IMD to provide the PNFS. The characteristics of the stimulation field may include, for example, a direction of stimulation within the field, a breadth of the stimulation field, a focus of stimulation within the stimulation field, a depth of the stimulation field relative to a reference point, such as the epidermis of the patient, or a nerve fiber diameter selection.

The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination. Additionally, the techniques may be used for shifting between different electrode combinations associated with different stimulation programs or program sets.

Shifting between electrode combinations in electrical stimulation device

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.

User interface with toolbar for programming electrical stimulation therapy

Techniques that involve application of one or more rules to a 'parent' program to generate a plurality of different 'child' programs are described. Each of the rules may define a respective electrode configuration modification, and each child program may be a variation of the parent based on a modification of the electrode configuration of the parent according to one of the rules. The systems or devices may generate further generations of child programs from a previous generation child program using the same one or more rules. The child programs may be provided to a user, so that the user may test the efficacy of the new programs, assisting the user in identifying desirable programs. The child programs may be relatively minor variations of the parent program, and the user may &#x201c;fine tune&#x201d; a generally desirable parent program by testing the child programs.

Rule-based stimulation program search

Telemetry signal strength is used for positioning a primary recharge coil of a recharging unit at a location proximate to an Implantable Medical Device (IMD) in preparation to recharge a rechargeable power source of the IMD. An antenna of the recharging unit is positioned proximate to the IMD, a telemetry session is initiated between the two devices, and a value indicative of the telemetry signal strength is obtained. Using a known correspondence between telemetry signal strength and recharge coupling efficiency for the IMD/recharging unit pair, the telemetry signal strength value is used to determine whether adequate recharge coupling may be achieved between the pair of devices. If so, a recharge session may be established. Otherwise, the antenna is repositioned and the process is repeated. The correspondence between telemetry signal strength and recharge coupling efficiency for the device pair may be developed empirically or using modeling.

Using telemetry coupling as a surrogate for recharger coupling

Growing community of inventors

Stanford, CA, United States of America

Jeffrey T Keacher