Medtronic, Inc.

Medtronic Sg, LLC

Medtronic Xomed, Inc.

Other

Nathan Andrew Torgerson

Steven M Goetz

Michael Thomas Lee

Warren W Ball

Roy L Testerman

Jeffrey T Keacher

Andrew H Houchins

Joseph J Nolan

Gary William King

Kenneth Timothy Heruth

Jon P Davis

Robert Leinders

Todd P Goblish

Garrett R Sipple

Ajinkya M Joglekar

Todd D Heathershaw

Matthew L Plante

Lynn A Davenport

James E Riekels

John Delfin Rodriguez

Jonathon E Giftakis

Rajeev Madhukar Sahasrabudhe

Lisa M Johanek

Reid K Bornhoft

Ashish Singal

Marc T Stein

Shyam Gokaldas

Todd V Smith

John W Forsberg

Earle Timothy Roberts

Irfan Z Ali

Ricardo Vallejo

David Leonardo Cedeno

Raymond F McMullen

Kevin J Kelly

Steven L Jensen

Wende L Dewing

Leroy L Perz

Donald L Villalta

Louis P Vera-Portocarrero

Melanie D Goodman Keiser

Brian Andrew Smith

Mark T Stein

David S Slack

Sudheendhar Raghavendran

Carl D Wahlstrand

John E Kast

David P Olson

James B Hissong

Timothy J Davis

John J Grevious

Michael J Schendel

Daniel C Oster

Robyn Lee Jagler

Andrew Jay Cleland

Matthew J Michaels

Brent A Huhta

David W Hoffman

Ye Tan

Scott E Straka

Jonathan P Bogott

Lachlan Davies

Sheryl McCammon

Timothy J Denison

Craig L Schmidt

Mark Turner Rise

Scott R Stanslaski

Dennis M Skelton

William G Howard

Paul H Stypulkowski

Joel A Anderson

Paul M Skarstad

William C Harding

James Zimmerman

Roger W Kelm

Christy Leslie Ludlow

Kevin L Bright

Curtis D Kinghorn

Nicholas D Buse

Shane A Self

Pamela Reed Kearney

Jean E Prather

Brian L Bechard

Ryan Gertenbach

Apparatus and methods for managing pain uses a single composite modulation/stimulation signal with variable characteristics to achieve the same results as separate varying electromagnetic signals, including spinal cord stimulation or peripheral nerve stimulation.

Method and apparatus for multi modal electrical modulation of pain using composite electromagnetic fields

An implantable medical device that includes a memory, stimulation circuitry configured to deliver electrical stimulation to a patient, and processing circuitry operably coupled to the memory. The processing circuitry is configured to: control the stimulation circuitry to output electrical stimulation therapy to a patient via a first electrode combination and control the stimulation circuitry to output a notification stimulation via a second electrode combination and interleaved with the electrical stimulation therapy. The notification stimulation may include an intensity above a perception level of the patient, and the second electrode combination may include an electrode disposed at an implant site of the implantable medical device.

Medical device patient alert using housing stimulation based on sensed event

Far field telemetry communications are conducted during recharge sessions between an external device and an implantable medical device. The two devices may not have been previously paired together for far field telemetry and may have been paired with other devices for far field telemetry during previous recharge sessions and/or programming sessions. Embodiments provide for temporary bonding of the two devices for far field telemetry during the recharge session. The implantable medical device of the recharge session may maintain a programming bond with an external device other than the external device conducting the recharge session. Safeguards against establishment of inadvertent programming sessions between the external device that has conducted a recharge session and implantable medical devices that may or may not be bonded to that external device are provided.

Far field telemetry communication with a medical device during a recharge session where a prior pairing with the medical device may not exist

The techniques of the disclosure describe example medical devices, systems, and methods for delivering electrical stimulation therapy to a patient. In one example, a medical device selects subsets of a plurality of therapy parameter sets that define electrical stimulation therapy, each subset including at least one therapy parameter set and less than all of the therapy parameter sets. Further, the medical device delivers, via a plurality of electrodes, electrical stimulation therapy according to each subset via a respective set of electrodes different from sets of electrodes of each other subset of the therapy parameter sets. The medical device iteratively delivers the electrical stimulation therapy according to the subsets of the therapy parameter sets via the respective sets of electrodes. Further, the medical device selects at least one subset of the therapy parameter sets that treat a condition of the patient for defining subsequent delivery of electrical stimulation to the patient.

Management of electrical stimulation therapy

A medical system implements a seizure detection algorithm to detect a seizure based on a first patient parameter. The medical system monitors a second patient parameter to adjust the seizure detection algorithm. In some examples, the medical system determines whether a seizure for which therapy delivery is desirable occurred based on a second patient parameter. If a target seizure occurred, and the seizure detection algorithm did not detect the target seizure, the medical system adjusts the seizure detection algorithm to detect the target seizure. For example, the medical system may determine a first patient parameter characteristic indicative of the target seizure detected based on the second patient parameter and store the first patient parameter characteristic as part of the seizure detection algorithm. In some examples, the first patient parameter is an electrical brain signal and the second patient parameter is patient activity (e.g., patient motion or posture).

Seizure detection algorithm adjustment

Apparatus and methods for managing pain uses a multiplexed modulation/stimulation signal to provide pain relief during spinal cord stimulation or peripheral nerve stimulation.

Method and apparatus for multi modal or multiplexed electrical modulation of pain using composite electromagnetic fields

An external device transfers a key to an implantable medical device over a proximity communication and then establishes a first far field communication session with the implantable medical device where the key is used for the first communication session. This first communication session may occur before implantation while the implantable medical device is positioned outside of the sterile field so that using a proximity communication is easily achieved. Once the implantable medical device is passed into the sterile field for implantation, the external device may then establish a second far field communication session with the implantable medical device where the last key that was used for the first communication session is again used for the second communication session which avoids the need for another proximity communication to occur within the sterile field.

Methods, devices, and systems for communicating with an implantable medical device of a last far field communication session during a subsequent far field communication session while using a same session key

Techniques for providing therapy to a patient via electrical stimulation are described. The techniques include, for example, determining, relative to a start time of providing the electrical stimulation, one or more efficacy times that correspond to an efficacy indicator, determining, according to the efficacy times, efficacy data items for the patient, comparing the efficacy data items with the efficacy indicator, and generating, based on the comparison, a prediction of an expected response to the therapy manifesting in the patient at a prospective time.

Stimulation response profiles

Implantable medical systems include implantable percutaneous medical leads and/or implantable medical lead extensions that have fewer conductors than distal electrodes, or distal connectors for extensions, by having one or more conductors be electrically coupled to multiple distal electrodes. The multiple distal electrodes may span a general area of a body of a patient that includes a specific point that requires therapy, such as multiple vertebral segments. Because all distal electrodes spanning the general area that are coupled to an active conductor will output the stimulation therapy, the specific point within the general area will receive the therapy even without identifying which electrode is most effective. Bipolar and unipolar stimulation modes may be used. Multiple leads may be used where each lead has more distal electrodes than conductors. Additionally, a single lead may have more distal electrodes than conductors while also carrying multiple stimulation waveforms.

Implantable medical leads having fewer conductors than distal electrodes

Shielded sheaths are placed over implantable medical leads and/or implantable medical lead extensions to provide shielding from electromagnetic energy and to prevent heating at the electrodes. The shielded sheaths include insulative bodies with shield layers such as conductive braided wire or conductive foil tubular structures. The shielded sheath may be implanted at the time of implanting the lead and/or lead extension. The shielded sheath may also be implanted at a later time after the lead and/or lead extension has previously been implanted. The shielded sheath may be anchored onto the lead or lead extension.

Methods of shielding implantable medical leads and implantable medical lead extensions

The techniques of the disclosure describe example medical devices, systems, and methods for interleaving a plurality of low-frequency electrical stimulation pulse trains delivered by a plurality of sets of electrodes of an implantable medical device (IMD) to effectively deliver a combined high-frequency electrical pulse train to a target tissue area. In one example, each set of the plurality of sets of electrodes has a unique anode and cathode. In another example, a clinician adjusts the size or shape of the target tissue area receiving the combined high-frequency electrical pulse train by selecting different combinations of the plurality of sets of electrodes.

Delivery of independent interleaved programs to produce higher-frequency electrical stimulation therapy

Techniques for therapy delivery are described. A processing circuit may adjust a first therapy parameter from a first level to a second level, and responsive to the adjustment of the first therapy parameter, compare a level of an evoked compound action potential (ECAP) generated from therapy delivery based on the adjusted first therapy parameter to an ECAP threshold. The processing circuit may adjust a second therapy parameter from a third level to a fourth level based on the comparison. The second therapy parameter is different than the first therapy parameter. The processing circuit may cause therapy delivery with the first therapy parameter at the second level and the second therapy parameter at the fourth level.

Therapy parameter selection based on ECAP feedback

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 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

The techniques of the disclosure describe example medical devices, systems, and methods for delivering stimulation therapy comprising a first set of a plurality of pulses having a first amplitude, and a second set of a plurality of pulses having a second amplitude greater than the first amplitude. The second amplitude is adjusted to an adjusted second amplitude based on second amplitude being less than or greater than activation threshold. The first amplitude is adjusted based on adjusted second amplitude, and therapy is delivered based at least one the adjusted first amplitude.

High frequency stimulation using low frequency titration gauge

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Andover, MN, United States of America

Nathan Andrew Torgerson