Medtronic, Inc.

Jiashu Li

Hank Bink

Kristin N Hageman

David A Dinsmoor

Duane L Bourget

Patrick A Helm

Christopher L Pulliam

Vinod Sharma

Sean Patrick Skubitz

Shai Ronen

Louis P Vera-Portocarrero

Ashutosh Chaturvedi

Andre D A Souza

Jeffery M Kramer

Phillip C Falkner

Andrew L Schmeling

Erik J Peterson

Andrew Jay Cleland

Melanie D Goodman Keiser

Brooke Kelley

Laura Ann Skarie

Andre DA Souza

An example method of cycling electric stimulation includes delivering, via an implantable device, electric stimulation to a patient in accordance with a first therapy program; monitoring, via the implantable device and while the electric stimulation is being delivered in accordance with the first therapy program, a biomarker; and responsive to determining the biomarker satisfies a threshold, delivering, via the implantable device, electric stimulation to the patient in accordance with a second therapy program that is different than the first therapy program.

Electric stimulation system

A sleeve for a medical lead includes a tubular body having a first open end and a second open end, a tubular wall extending between the first and second ends and defining a hollow center, and a longitudinal axis extending through the hollow center. A first pocket is disposed in the tubular wall and having a curved transverse cross section and a first access opening at the first open end of the tubular body. A medical lead system includes a medical lead and the sleeve configured to slide over the medical lead and be adjacent to the electrode region.

Imaging markers for stimulator leads

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 therapy. In some examples, a medical device includes stimulation generation circuitry configured to deliver a first stimulation pulse to a patient, sensing circuitry configured to sense the first stimulation pulse, and processing circuitry. The processing circuitry is configured to determine that a value of a characteristic of the sensed first stimulation pulse exceeds a target stimulation pulse value and responsive to determining that the value of the characteristic of the sensed first stimulation pulse exceeds the target stimulation pulse value, change a first value of a parameter to a second value of the parameter that at least partially defines a second stimulation pulse deliverable by the stimulation generation circuitry after the first stimulation pulse was sensed.

Controlling electrical stimulation based on a sensed stimulation signal

Systems, devices, and techniques are described for determining a posture state of a patient based on detected evoked compound action potentials (ECAPs). In one example, a medical device includes stimulation circuitry configured to deliver electrical stimulation and sensing circuitry configured to sense a plurality of evoked compound action potential (ECAP) signals. The medical device also includes processing circuitry configured to control the stimulation circuitry to deliver a plurality of electrical stimulation pulses having different amplitude values, control the sensing circuitry to detect, after delivery of each electrical stimulation pulse of the plurality of electrical stimulation pulses, a respective ECAP signal of the plurality of ECAP signals, and determine, based on the plurality of ECAP signals, a posture state of the patient.

Determining posture state from ECAPs

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

Techniques are disclosed for using a cardiac signal sensed via a plurality of electrodes disposed on one or more leads implanted within an epidural space of a patient to control spinal cord stimulation (SCS) therapy. In one example, an implantable medical device (IMD) senses an electrical signal via a plurality of electrodes disposed on one or more leads implanted within an epidural space of a patient. Processing circuitry determines, from the electrical signal, one or more cardiac features indicative of activity of a heart of the patient. The processing circuitry controls, based on the one or more cardiac features, delivery of SCS therapy to the patient.

Sensing cardiac signals with leads implanted in epidural space

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

An example method includes obtaining an image of a lead implanted in a patient, the lead including one or more electrodes positioned along a longitudinal axis of the lead and a plurality of orientation markers; determining, in the image, respective locations of the electrodes and respective locations of the orientation markers; obtaining a template model corresponding to the lead; determining a transform between the determined locations of the one or more electrodes and the plurality of orientation markers and locations of corresponding electrodes and orientation markers in the template model; and determining the rotational orientation of the lead based on the transform.

Identification of orientation of implanted lead

A lead body is operable to be implanted proximate a target nerve tissue of a patient. A sensing electrode is configured to sense biopotentials over a first partial circumference of the lead body. A stimulation electrode is configured to deliver stimulation energy over a second partial circumference of the lead body. A signal generator is electrically coupled to the stimulation electrode and a sensing circuit is coupled to the sensing electrode. A processor is operable to apply a stimulation signal to the stimulation electrode via the signal generator and, via the sensing circuit, sense an evoked response to the stimulation signal that propagates along a neural pathway.

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Mounds View, MN, United States of America

Jiashu Li