Medtronic, Inc.

Lance Zirpel

Dwight E Nelson

Thaddeus S Brink

Xin Su

Xuan K Wei

Sudha B Iyer

Adam P Steiner

David A Dinsmoor

Erik J Peterson

Blake A Hedstrom

Devices, systems, and methods may manage therapy delivery to a patient based on one or more physiological markers. In some examples, a method includes detecting a physiological marker that occurs prior in time to a dysfunctional phase of a physiological cycle, wherein a dysfunctional state of the physiological cycle occurs during the dysfunctional phase without treatment, responsive to detecting the physiological marker, initiating a first phase of the physiological cycle having a duration of time. The method may also include, responsive to the first phase elapsing, controlling a therapy delivery module to deliver neurostimulation therapy during a second phase that begins prior to the dysfunctional phase, wherein the neurostimulation therapy is configured to treat the dysfunctional state.

Managing therapy delivery based on physiological markers

An implantable medical device (IMD) includes a memory configured to store a set of therapy parameters for subsensory electrical stimulation of a patient; and therapy delivery circuitry configured to deliver the subsensory electrical stimulation to at least one of a sacral nerve or tibial nerve based on the stored set of therapy parameters to provide immediate therapeutic effect caused by the ongoing delivery of the subsensory electrical stimulation to address incontinence, wherein a stimulation intensity of the subsensory electrical stimulation is less than 80% of a stimulation intensity at a sensory threshold, and wherein the patient does not perceive delivery of the subsensory electrical stimulation and perceives delivery of stimulation at the sensory threshold.

Incontinence therapy

This disclosure describes methods, systems, and devices configured to determine a timing of a future bladder related event of a patient. For example, a system includes processing circuitry configured to identify a timing of a plurality of bladder related events of a patient, determine, based on the timing of the plurality of bladder related events of the patient, a probability to experience a bladder related event function for the patient, the probability to experience a bladder related event function indicating a probability that the patient will experience a bladder related event at an elapsed time after a previous bladder related event, predict, based on the probability to experience a bladder related event function, a timing of a future bladder related event, and control delivery of a therapy to the patient based on the predicted timing of the future bladder related event.

Monitoring bladder dysfunction using a probability function

The disclosure describes example of subsensory electrical stimulation for providing therapy for incontinence. An implantable medical device (IMD) includes a memory configured to store a set of therapy parameters for subsensory electrical stimulation of a patient. The delivery of the subsensory electrical stimulation results in a therapeutic effect for incontinence therapy at a stimulation intensity that is in range of approximately 50% to 80% of a stimulation intensity at a sensory threshold, and the patient does not perceive delivery of the subsensory electrical stimulation and perceives delivery of stimulation at the sensory threshold. The IMD also includes therapy delivery circuitry configured to deliver the subsensory electrical stimulation based on the stored set of therapy parameters, including cycling the delivery of the subsensory electrical stimulation between an on-cycle and an off-cycle.

Techniques for delivering electrical stimulation therapy comprising a complex variation to at least one electrical stimulation parameter are described. In one example, processing circuitry of an implantable medical device (IMD) identifies a plurality of electrical stimulation parameters for at least one pulse train of electrical stimulation. The processing circuitry defines a complex variation to at least one electrical stimulation parameter of the plurality of electrical stimulation parameters. The processing circuitry modifies the at least one pulse train of electrical stimulation by introducing the complex variation to the electrical stimulation parameter function and controls a stimulation generator of the IMD to generate, as modified, the at least one pulse train of electrical stimulation.

Complex variation of electrical stimulation therapy parameters

In general, techniques, methods, systems, and devices for delivering high frequency neurostimulation to control one or more pelvic disorders are described. In one example, a method includes identifying, by a medical device configured to be at least partially implanted in a patient, an indication to inhibit bladder activity. The medical device generates, in response to identifying the indication, electrical stimulation therapy comprising first electrical stimulation pulses comprising a first frequency greater than or equal to about 500 Hertz and less than or equal to about 5,000 Hertz. Further, the medical device delivers the electrical stimulation therapy to a target nerve selected from a group consisting of: a sacral nerve, a pelvic nerve, a tibial nerve, and a pudendal nerve of the patient.

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Lino Lakes, MN, United States of America

Lance Zirpel