Medtronic, Inc.

Steven L Jensen

Dwight E Nelson

Nathan Andrew Torgerson

Robert M Skime

Robert Leinders

Jianping Wu

John W Forsberg

John J Grevious

Raymond F McMullen

Marc T Stein

Craig L Schmidt

Paul M Skarstad

Ruchika Singhal

Rahul Gupta

Christopher M Arnett

Richard M Powell

Allen Dale Almendinger

John Delfin Rodriguez

Rahul Agarwal

Ruchika Singal

A medical device detects a previously defined event, and controls delivery of therapy to a patient according to therapy information associated with the previously defined event. In exemplary embodiments, the medical device enters a learning mode in response to a command received from a user, e.g., the patient or a clinician. In such embodiments, the medical device defines the event, collects the therapy information, and associates the therapy information with the defined event while operating in the learning mode. In some embodiments, the medical device defines the event based on the output of a sensor that indicates a physiological parameter of the patient during the learning mode. The sensor may be an accelerometer, which generates an output that reflects motion and/or posture of the patient. The medical device may collect therapy information by recording therapy changes made by the user during the learning mode.

Automatic therapy adjustments

The disclosure relates to the delivery of electrical stimulation therapy to the brain of a patient, e.g., to treat or otherwise manage a patient disorder. In one example, the disclosure relates to a method comprising generating electrical stimulation via a medical device; delivering the electrical stimulation at a first frequency to a brain of a patient when the bioelectrical brain signals of the patient oscillate at a second frequency, where the second frequency corresponds to pathological brain signals of the patient, where the electrical stimulation is selected to entrain the bioeiectrical brain signals of the patient; and adjusting the delivered electrical stimulation from the first frequency to a third frequency, where adjusting the delivered electrical stimulation changes the bioelectrical brain signal oscillations to a fourth frequency different from the second frequency. The fourth frequency may correspond to an oscillation frequency of non-pathological brain signals of the patient.

Entrainment of bioelectrical brain signals

Various embodiments concern sensing a LFP signal from one or more electrodes, measuring the amplitude of the signals over a period of time, and calculating a plurality of variance values from the amplitude, wherein each of the variance values correspond to the variance of the amplitude for a different interval of time of the period of time with respect to the other variance values. Such embodiments may further include assessing the relative level of neural activation of an area of the brain based on the variance values, wherein the area of the brain is assessed to have a relatively higher level of neural activation when the variance is relatively higher and the area of the brain is assessed to have a relatively lower level of neural activation when the variance is relatively lower.

Method and apparatus for assessing neural activation

This disclosure describes techniques for delivering electrical stimulation at one or more phases relative to an ongoing oscillating signal in a patient, and then mapping the response to the oscillating signal. The techniques may reduce or eliminate the oscillating signal. In one example, the disclosure is directed to a method that includes delivering a set of first electrical stimulation at a plurality of phases relative to an oscillating signal, measuring a response in the oscillating signal to the set of first electrical stimulation after delivering electrical stimulation at each respective phase of the plurality of phases, determining a phase at which to deliver second electrical stimulation based on the measured responses, and delivering the second electrical stimulation to the patient at the determined phase to produce a therapeutic effect.

Electrical stimulation based on phase response mapping

Bioelectrical signals may be sensed within the brain by two or more electrodes to determine characteristics of a function of the brain. The signals obtained by the electrodes may be plotted over time to determine whether the brain function exhibits a normal or an abnormal pattern. If the brain function exhibits an abnormal pattern, an implantable medical device may dynamically determine based on the abnormal pattern and a previously-obtained plot associated with normal brain function, an appropriate electrical stimulation therapy. Application of the appropriate electrical stimulation therapy causes the brain function to shift from the abnormal pattern to the normal pattern.

Medical method and device for monitoring a neural brain network

The disclosure relates to an electrical trial stimulator that stores multiple applications to selectively emulate the operation of different chronically implanted stimulators. Each application corresponds to a different chronically implanted stimulator. Upon selection of a particular application, the stimulator executes a set of instructions to emulate the operation of a chronically implanted stimulator that corresponds to the application. The multi-application stimulator permits a physician to select an application for stimulation therapy, and evaluate efficacy of a particular chronically implanted stimulator. In addition, the physician may select any of the other stimulation applications to emulate other stimulators. The different stimulation applications may correspond to different stimulators that deliver a similar therapy, e.g., stimulators designed to deliver spinal cord stimulation for alleviation of chronic pain. Alternatively, the applications may correspond to stimulators that deliver different types of therapy, e.g., stimulators that deliver spinal cord, deep brain, gastrointestinal, or pelvic floor stimulation.

Multi-application trial stimulator

A stream processor for an implantable medical device provides rapid computation using simple architecture and low power in which each input data sample is processed in parallel by a separate and independent central processing unit executing similar or identical kernel code consisting of the following elements. A housing contains a power source. A controller with memory coupled to the power source. A first physiological sensing apparatus and at least a second physiological sensing apparatus is coupled to the controller. A first stream processing element is coupled to the first physiological sensor and coupled to the controller. At least a second stream processing element is coupled to the second physiological sensor and coupled to the controller.

Implantable medical device stream processor

An implantable medical device includes a control circuit for controlling the operation of the device and for obtaining physiological data from a patient in which the medical device is implanted. The implanted device also includes a communication circuit for transmitting the physiological data to an external device. A first power source is coupled to the control circuit and provides power to the control circuit. A second power source is coupled to the communication circuit and provides power to the communication circuit.

Implantable medical device with a dual power source

In the embodiment of the invention, apparatus and method provide flexibility in generating a stimulation waveform (that comprises at least a stimulation pulse) to an electrode of an Implantable Neuro Stimulator (INS). The waveform is synthesized for each rate period interval. A portion of the rate period interval is identified, in which the portion comprises at least one phase. During each phase, the stimulation waveform is synthesized by a waveform controller and a waveform generator. The waveform controller utilizes waveform parameters, e.g. the initial value, final value, and step time duration, to form a digital signal to the waveform generator. The waveform generator utilizes the digital signal to form the synthesized waveform.

Wave shaping for an implantable medical device

A method for fast median filtering in an implantable medical device is disclosed that provides rapid filtering using computational mechanisms with following elements. A new sample value is received into a buffer. An oldest sample value location is identified in a MIN-heap and a MAX-heap. A new sample value location is identified in either the MIN-heap or the MAX-heap by comparing the new sample value to a median value. The new sample value is placed into the oldest sample value location, if the MIN-heap or MAX-heap identified for the new sample value location is the same as the MIN-heap or MAX-heap identified for the oldest sample value location. A MIN-heap top or MAX-heap top is moved from the heap not containing the oldest value into the location of the oldest sample and the new sample is placed into the location of the MIN-heap top or MAX-heap top moved from the heap not containing the oldest value, if the heap identified for the new sample is not the same as the heap identified for the oldest sample. The MAX-heap is rebalanced so the MAX-heap top contains the highest value in the MAX-heap and the MIN-heap is rebalanced so the MIN-heap top contains the lowest value in the MIN-heap. The median value is calculated by averaging the MIN-heap top plus the MAX-heap top. The method for fast median filtering in an implantable medical device can also be expressed as a computer software product that includes a medium readable by a processor.

Implantable medical device fast median filter

A stream processor for an implantable medical device provides rapid computation using simple architecture and low power in which each input data sample is processed in parallel by a separate and independent central processing unit executing similar or identical kernel code consisting of the following elements. A housing contains a power source. A controller with memory coupled to the power source. A first physiological sensing apparatus and at least a second physiological sensing apparatus is coupled to the controller. A first stream processing element is coupled to the first physiological sensor and coupled to both the power source and the controller. At least a second stream processing element is coupled to the second physiological sensor and coupled to both the power source and the controller.

An apparatus and method that will allow for external communication, via an external programmer, for positive device identification and for retrieval of device or patient information stored by an implantable medical device with a depleted power source. The external programmer will deliver energy to a secondary power source located inside the implanted device using RF telemetry sufficient to charge up the secondary power source, e.g., a small capacitor. The capacitor will charge up immediately within milliseconds. Once the secondary power source is sufficiently charged, it can be used to power up a controller having the stored information in the implantable medical device. Once the controller is operational, the implanted device will transmit device and patient information to the external programmer via RF telemetry.

Apparatus and method for allowing immediate retrieval for information and identification from an implantable medical device having a depleted power source

A cardiac pacemaker improves battery longevity by automatically providing a safe threshold and an associated pulse width leading to minimum current drain. The pacemaker stores a matrix of current drain characteristics for all of the possible pulse width-voltage pairs, and a revisable strength-duration curve for a patient. Either periodically or as a result of a loss-of-capture episode--whichever occurs first--the pacemaker calculates for each possible pulse width, a new threshold value based upon a measured rheobase and a derived chronaxie. Each threshold is multiplied by a predetermined safety margin. The pacemaker chooses as the pacing stimulation signal, the voltage-pulse width pair having the lowest associated current drain, and satisfying the desired safety margin.

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Andover, MN, United States of America

Steven L Jensen