Medtronic, Inc.

Lisa M Johanek

Carl D Wahlstrand

Nathan Andrew Torgerson

Gabriela C Molnar

Paul W Wacnik

John E Kast

Phillip C Falkner

Dale F Seeley

Louis P Vera-Portocarrero

Andrew Jay Cleland

Melanie D Goodman Keiser

Sheryl McCammon

Ye Tan

Glenna L Case

Lachlan Davies

Sheryl Mccammon

In some examples, a medical device is configured to deliver high dose electrical stimulation therapy to a patient by at least generating and delivering an electrical stimulation signal having a relatively high duty cycle, and a stimulation intensity less than a perception or paresthesia threshold intensity level for the patient. The pulses may each have a relatively low amplitude, but due at least in part to a relatively high number of pulses per unit of time, the electrical stimulation signal may be high enough to elicit a therapeutic response from the patient. In some examples, the plurality of pulses may have a duty cycle in a range of about 5% to about 50%. Following the generation and delivery of the plurality of pulses, one or more recharge pulses for the plurality of pulses may be delivered.

High duty cycle electrical stimulation therapy

In some examples, a medical device is configured to automatically determine a paresthesia threshold or a perception threshold of a patient in a second posture based on the paresthesia threshold or perception threshold of that patient in a first posture. The medical device may deliver an electrical stimulation signal to a patient and determine the paresthesia threshold or perception threshold for the patient in the first posture. The medical device may change the intensity of the electrical signal and receive an indication from the patient that they are experiencing paresthesia or perceiving the electrical stimulation signal. The medical device may then automatically determine a predicted paresthesia threshold or predicted perception threshold for a second posture based on the paresthesia threshold or perception threshold.

Posture-based paresthesia threshold or perception threshold determination

In some examples, a medical device is configured to deliver high dose electrical stimulation therapy to a patient by at least generating and delivering an electrical stimulation signal having a relatively high duty cycle, and a stimulation intensity less than a perception or paresthesia threshold intensity level for the patient. The pulses of the electrical stimulation signal may each have a relatively low amplitude, but due at least in part to a relatively high number of pulses per unit of time, a dose of the electrical stimulation may be high enough to elicit a therapeutic response from the patient.

In some examples, a medical device is configured to deliver sub-threshold electrical stimulation therapy to a patient at a stimulation intensity that is significantly less than a perception or paresthesia threshold intensity level for the patient. The medical device may determine the particular intensity level for the patient through a titration process. The medical device may titrate automatically or based upon the input of the patient, a clinician or a physician.

Titration for sub-threshold electrical stimulation therapy

An introducer for a medical lead, the introducer having an arcuate component for creating an arcuate path in a patient. When used to percutaneously implant a medical device such as a medical lead with electrodes, the implanted lead has an arcuate configuration. The implanted lead can be used to at least partially encircle or bracket a region of chronic pain and provide therapeutic electrical signals to the region.

Arcuate introducer

In some examples, a method may include delivering an electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a first electrical stimulation pulse delivered to the patient via a first electrode and a second electrical stimulation pulse delivered to the patient via a second electrode, wherein the first electrical stimulation pulse and second electrical stimulation pulse are delivered as paired pulses with respect to each other and a combination of the first electrical stimulation pulse and the second electrical stimulation pulse evoke a compound action potential within the patient; sensing the compound action potential evoked by the combination of the first electrical stimulation pulse and the second electrical stimulation pulse; and adjusting one or more parameters of the electrical stimulation therapy based on the sensed compound action potential.

Paired stimulation pulses based on sensed compound action potential

In some examples, the disclosure relates to system, devices, and techniques for delivering dorsal column stimulation. One or more locations for dorsal column stimulation may be identified based on sensed signals evoked by delivery of stimulation to a dorsal root and/or peripheral nerve of a patient. In some examples, an IMD may deliver dorsal column stimulation in combination with dorsal root stimulation to a patient to treat a patient condition.

Dorsal column stimulation therapy

A hub () includes a first lead receptacle having a plurality of contacts () for electrically coupling a lead to an implantable electrical device. The hub further contains a second lead receptacle having a plurality of contacts for electrically coupling a lead to the implantable electrical device. At least one of the plurality of contacts of the first receptacle is a contact of the second receptacle. Such a configuration may allow for the overall size of the hub to be reduced relative to a hub where each discrete contact of the hub corresponds to a discrete contact or electrical channel of the implantable electrical device.

Hub for implantable medical leads

A medical lead includes a plurality of electrodes on an annular distal end portion of the lead. The electrodes may be arranged along a circle concentric with the center of a void defined by the annular portion. The annular medical lead design is well suited for application of electrical signal therapy to the suborbital nerve at its point of exit from the inferior orbital foramen in the skull.

Electrode arrangements for suborbital foramen medical lead

Devices, systems, and techniques for delivering electrical stimulation according to a spatial electrode movement pattern are disclosed. Moving electrical stimulation between electrodes in a repeatable movement pattern may provide a therapeutic sensation to a patient. In one example, a system may include a plurality of electrodes configured to be implanted within a patient, at least one processor, and a therapy module. The at least one processor may be configured to receive a spatial electrode movement pattern that defines a sequence with which electrical stimulation is moved between the plurality of electrodes. The therapy module may be configured to deliver electrical stimulation to the patient based on the spatial electrode movement pattern. The therapy module may also be configured to move the electrical stimulation between each of the plurality of electrodes according to the spatial electrode movement pattern and repeat the spatial electrode movement pattern when delivering the electrical stimulation to the patient.

Movement patterns for electrical stimulation therapy

Devices, systems, and techniques for ramping one or more parameter values of electrical stimulation are disclosed. An implantable medical device may increase or decrease a parameter value, e.g., amplitude or pulse width, over time to reach a target value of the parameter. In one example, a memory may be configured to store a plurality of amplitude ramp schedules. At least one processor may be configured to obtain a stimulation parameter set that at least partially defines an electrical stimulation therapy, select one of the plurality of amplitude ramp schedules based on a signal frequency of the stimulation parameter set, and increase an amplitude of the electrical stimulation therapy during a ramp period defined by the selected amplitude ramp schedule.

Ramping parameter values for electrical stimulation therapy

A medical lead includes a lead body having a proximal end for electrical connection to an implantable electric signal generator and a distal end portion having a plurality of electrodes extending in a helical manner longitudinally along the distal end portion. Adjacent helical electrodes may be offset, for example, 90 degrees or 180 degrees. The helical electrodes may extend less than, greater than, or 360 degrees. The electrode arrangement provides increased surface area, improving the capability of positioning the lead against the nerve as desired.

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White Bear Lake, MN, United States of America

Lisa M Johanek