Medtronic, Inc.

Joseph J Nolan

Steven M Goetz

Dennis M Skelton

Jon P Davis

Rajeev Madhukar Sahasrabudhe

Shyam Gokaldas

Andrew H Houchins

Nathan Andrew Torgerson

Jeffrey T Keacher

Gary William King

Kenneth Timothy Heruth

Michael Thomas Lee

Roy L Testerman

Ruth Elinor Bauhahn

Keith Alan Miesel

Duane L Bourget

James Zimmerman

Dennis J Bourget

David P Olson

Todd V Smith

Wende L Dewing

Shahram Malekkhosravi

Jay T Eisch

Nicholas A Delisi

Philip R LaBrosse

James A Zimmerman

Ruth E Bauhahn

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 programming session for an implantable medical device that includes a posture responsive therapy mode includes at least two phases. In a first phase, a first set of therapy parameter values are modified while the posture responsive therapy mode is deactivated. In the posture responsive therapy mode, the medical device automatically selects one or more therapy parameter values that define therapy delivered to a patient based on a detected posture state. In a second phase, the posture responsive therapy mode is activated and a second set of therapy parameter values are adjusted after observing a patient response to the posture responsive therapy delivered with the first set of therapy parameter values selected during the first phase. The second set of therapy parameter values may, for example, define the patient posture states or the modification profiles with which the medical device adjusts therapy upon detecting a posture state transition.

Programming posture responsive therapy

Techniques for providing an indication of coupling between medical devices are disclosed. For example, when a programming device and a telemetry module are coupled, the telemetry module provides a first indication, and the programming device provides a second indication substantially similar to the first indication. The indications may be, for example, colors, and different indications may signify communication with different implantable medical devices, programming different therapies, or use of different applications of the programming device.

Indication of coupling between medical devices

Techniques are disclosed for tuning a frequency at which an external device transcutaneously transfers energy. The transferred energy may be used to charge a rechargeable power source of an implantable medical device (IMD) and/or to power the IMD directly. One embodiment relates to a charging system that may comprise a circuit to drive a primary coil of an external device at a drive frequency and a control circuit to tune the drive frequency based on a characteristic of a monitored signal that is associated with the primary coil. The characteristic is not present when the primary coil is being driven at a resonant frequency of the system. In a specific example, the characteristic comprises a stub pulse and the control circuit is configured to tune the drive frequency based on at least one of a relative timing and a width of the stub pulse.

Recharge tuning techniques for an implantable device

The disclosure provides a system that displays a posture state indication to a user. A posture state indication represents the current posture state of the patient, which may be a combination of patient posture and activity. As a patient changes posture and activity throughout a daily routine, a posture state detector may generate a posture state value that may be used to categorize the patient's posture or posture and activity level as one of multiple posture states used to adjust therapy. The posture state may be associated with one of multiple posture state indications that may be presented to the patient. The posture state indication shows the patient the posture state currently detected by the posture state detector. The posture state indication may help the patient to effectively monitor therapy changes due to automatic, semi-automatic or patient-directed therapy adjustments made as a function of posture state.

Posture state display on medical device user interface

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 describes a method and system that allows a user to manage multiple groups of stimulation programs that provide stimulation therapy. A physician may prepare a plurality of programs, arranged in groups that each focus on one area, that the patient may evaluate in an effort to determine if any programs provide efficacious therapy. Since the patient may be evaluating many groups by using a patient programmer, managing the groups may be difficult. The patient programmer may enable the patient to hide ineffective groups to minimize the number of groups available for therapy. In addition, the programmer may allow the patient to mark each group or program as effective or ineffective, to more easily manage groups and programs during stimulation therapy. In addition, the patient may unhide a group or program if the patient desires to reevaluate a formerly hidden option.

Management of multiple stimulation program groups

The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include an external programmer comprising a user interface that receives user input defining therapy parameter values for delivery of therapy to a patient, and user input associating one or more of the therapy parameter values with a plurality of posture states based on user input, a processor that automatically defines therapy parameter values for delivery of therapy to a patient when the patient occupies the posture states based on the association, and an implantable medical device that delivers the therapy to the patient in response to detection of the posture states.

Defining therapy parameter values for posture states

A user may modify a stimulation parameter in a plurality of stimulation programs with a single adjustment. During stimulation therapy, the user, such as a patient, may desire to change a parameter of the plurality of stimulation programs. The patient may press a single button on an external programmer to make the parameter change, or global adjustment, to all of the plurality of stimulation programs. This global adjustment eliminates the need for the patient to navigate through each of the plurality of stimulation programs separately and adjust the parameter. Additionally, changing the plurality of stimulation programs may be desirable for uniform stimulation therapy between programs used by the patient. The external programmer may calculate an appropriate parameter change for each stimulation program to keep parameter ratios equal between the plurality of stimulation programs.

Global parameter adjustment for multiple stimulation programs

In general, the disclosure relates to the delivery of therapy according to a detected posture state of a patient. The disclosure contemplates a variety of techniques for managing therapy delivered to a patient, including patient and clinician interaction with a medical device configured to deliver therapy according to posture state. In one example, the disclosure relates to a technique including delivering a first therapy to a patient via a medical device, the first therapy associated with a first posture state of the patient; receiving an indication from a user indicating that a second therapy should be delivered, the second therapy associated with a second posture state of the patient; and delivering the second therapy to the patient instead of the first therapy based on the indication.

Patient interaction with posture-responsive therapy

In general, the disclosure relates to the delivery of therapy according to a detected posture state of a patient. The disclosure contemplates a variety of techniques for managing therapy delivered to a patent, including patient and clinician interaction with a medical device configured to deliver therapy according to posture state. In one example, the disclosure relates to a technique including receiving an indication from an external device to resume delivery of therapy to a patient that was previously turned off, wherein the therapy that was previously turned off comprises therapy delivered to the patient according to a detected posture state of the patient; obtaining therapy information defining the therapy; and resuming the delivery of therapy to the patient in response to the receipt of the indication, wherein the delivery of therapy is resumed according to the obtained therapy information.

In general, the disclosure relates to the delivery of therapy according to a detected posture state of a patient. The disclosure contemplates a variety of techniques for managing therapy delivered to a patent, including patient and clinician interaction with a medical device configured to deliver therapy according to posture state. In one example, the disclosure relates to a technique including obtaining an operational status of a therapy group from a medical device, wherein the medical device is configured to deliver therapy to a patient according to a detected posture state of the patient; and presenting the operational status of the therapy group via an external device, wherein presenting the operational status of the therapy group comprises presenting whether the therapy group is active for delivery of therapy.

Growing community of inventors

Minnetonka, MN, United States of America

Joseph J Nolan