Medtronic, Inc.

Thaddeus S Brink

Dwight E Nelson

Xin Su

Lance Zirpel

Blake A Hedstrom

Ashish Singal

Adam P Steiner

David A Dinsmoor

Scott R Stanslaski

Jamu Alford

Christopher L Pulliam

David L Carlson

Duane L Bourget

Erik J Peterson

Sarah J Offutt

David E Linde

Douglas Scott Cerny

Jerel K Mueller

Rene A Molina

Benjamin P Isaacson

Abbey Beuning Holt Becker

Nicholas D Buse

Caleb C Zarns

This disclosure relates to devices, systems, and methods for autotitrating stimulation parameters. In one example, a method includes controlling an implantable medical device to deliver electrical stimulation to a patient according to a plurality of electrical stimulation parameter sets, each electrical stimulation parameter set of the plurality of electrical stimulation parameter sets defining a respective electrical stimulation signal deliverable to the patient, obtaining, by one or more processors and for each electrical stimulation parameter set of the plurality of electrical stimulation parameter sets, a respective signal representative of an electrical response sensed from the patient in response to the electrical stimulation delivered to the patient according to the respective electrical stimulation parameter set, and determining, by the one or more processors and based on the obtained respective signals, a primary electrical stimulation parameter set that defines electrical stimulation therapy deliverable to the patient by the implantable medical device.

Autotitration of therapy using detected electrical activity

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 example method includes determining, by an implantable medical device (IMD), an electrode of a plurality of electrodes of a lead to be used to deliver electrical stimulation to a patient at a particular time; selecting, by the IMD and based on the determined electrode, a set of electrodes of the plurality of electrodes; and sensing, by the IMD and via the selected set of electrodes, electrical signals of the patient at the particular time.

Dynamically optimized neural sensing

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 devices, systems, and techniques for identifying and treating bladder dysfunction. In one example, a method includes identifying one or more focal points at respective locations of bladder tissue of a bladder of a patient, the one or more focal points initiating coordinated contractions of a detrusor muscle. The method may also, or alternatively, include ablating, for each of the one or more focal points, a respective portion of the bladder tissue at the respective location of the focal point. Ablation of these targeted portions of the bladder tissue may reduce the coordinated contractions of the detrusor muscle and alleviate overactive bladder symptoms.

Ablation therapy to disrupt coordinated bladder contractions

An example method includes receiving, by an implantable device and from an external device, an energy signal; transducing, by the implantable device, the energy signal into electrical power; outputting, by the implantable device and to the external device, a feedback signal that represents an absolute level of the electrical power transduced from the energy signal, wherein the feedback signal includes a first portion that represents a relative level of the electrical power transduced from the energy signal and a second portion that represents a reference voltage level; and delivering, by the implantable device, a level of electrical stimulation therapy proportional to the absolute level of the electrical power transduced from the energy signal.

Externally powered implantable stimulator

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.

High frequency neurostimulation for pelvic symptom control

In one example, a method including generating electrical stimulation therapy with a frequency of approximately 500 hertz or greater, and controlling delivery of the electrical stimulation therapy to a patient via a medical device between at least one of contractions of a bladder or contractions of a bowel of a patient, wherein the electrical stimulation therapy comprises electrical stimulation therapy configured to inhibit contraction of the bladder when the electrical stimulation is delivered between the contractions of the bladder, wherein the electrical stimulation therapy comprises electrical stimulation therapy configured to inhibit contraction of the bowel when the electrical stimulation is delivered between the contractions of the bowel, and wherein at least one of the generating and controlling is performed via one or more processors.

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Saint Paul, MN, United States of America

Thaddeus S Brink