Medtronic, Inc.

Xin Su

Dwight E Nelson

David A Dinsmoor

Thaddeus S Brink

Blake A Hedstrom

Timothy J Denison

Lance Zirpel

Jason E Agran

Xuan K Wei

Gregory F Molnar

Ashish Singal

Sudha B Iyer

Ryan D Willemsen

Kira Stolen

Peng Cong

Jianping Wu

Erik J Peterson

Timothy Denison

Louis P Vera-Portocarrero

Brett Knappe

Timothy J Ness

In some examples, a technique for delivering electrical stimulation therapy to a patient includes determining, by processing circuitry, one or more cycle settings associated with delivery of the electrical stimulation therapy, determining, by the processing circuitry, a cycle time period associated with each cycle setting, and delivering, by a medical device, electrical stimulation therapy based on the determined cycle settings and the determined cycle time periods. Each cycle setting may define an on-cycle, during which electrical stimulation is delivered, and an off-cycle, during which electrical stimulation is not delivered. The technique further may include delivering electrical stimulation to the patient to provide one or more reminders to the patient, such as a reminder to void or a reminder of the existence of electrical stimulation.

Incontinence therapy

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

This disclosure relates to methods, devices, and systems for delivering and adjusting stimulation therapy. In one example, a method comprising delivering, by a stimulation electrode, electrical stimulation as a candidate therapy to a patient according to a set of candidate therapy parameters, the stimulation electrode located in proximity to the dorsal column of a patient; sensing, by a sensing electrode, an electrically evoked compound action potential (eECAP) signal in response to the delivery of the electrical stimulation; and classifying, by a processor, the sensed eECAP signal generated in response to the application of the candidate therapy relative to an eECAP baseline is disclosed.

Dorsal spinal column characterization with evoked potentials

Example systems for positioning an implantable electrode may include a stimulation circuitry, a sensing circuitry, and processing circuitry. The stimulation circuitry may generate electrical stimulation deliverable to a patient. The sensing circuitry may sense electromyographic (EMG) responses. The processing circuitry may control the stimulation circuitry to deliver the electrical stimulation at a plurality of different stimulation metric levels at each of a plurality of different positions. The processing circuitry may sense, via the sensing circuitry, electromyographic (EMG) responses to the electrical stimulation. The processing circuitry may score one or more of the different positions for chronic implantation of at least one implantable electrode. The scoring may be based on a stimulation metric level greater than a predetermined metric threshold sufficient to evoke at least some of the sensed EMG responses, and a level of the at least some of the sensed EMG responses.

Lead placement for nerve stimulation

A medical device system includes an IMD configured to deliver a plurality of stimulation vectors and processing circuitry. The processing circuitry is configured to determine strength-duration curve data for the plurality of stimulation vectors, the strength-duration curve data representing, for respective pulse widths and stimulation vectors, a corresponding strength of electrical stimulation that evokes a physiological response, compare respective slopes of the strength-duration curve data for the plurality of stimulation vectors to one another, select at least one stimulation vector of the plurality of stimulation vectors based on the comparison of the respective slopes of the strength-duration curve data for the plurality of stimulation vectors, and cause the IMD to deliver the electrical stimulation to a neural target via the selected at least one stimulation vector.

Stimulation vector selection using pulse width data

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may include processing circuitry configured to control a medical device to deliver a first electrical stimulation according to a first value of a first stimulation parameter of the plurality of stimulation parameters and a first value of a second parameter of the plurality of stimulation parameters, receive an input representative of an efficacy of the first electrical stimulation delivered to the patient according to the first value of the first stimulation parameter and the first value of the second parameter, select, based on the input and the relationship between the plurality of stimulation parameters, a second value of at least one of the first stimulation parameter or the second stimulation parameter, and control the medical device to deliver a second electrical stimulation according to the second value.

Selection of parameters for electrical stimulation

In some examples, a method including determining a chronaxie of evoked threshold motor responses from electrical stimulation delivered to a sacral nerve of a patient; and delivering, based on the determined chronaxie, electrical stimulation therapy, configured to treat a patient condition, to the sacral nerve having a pulse width at or near the identified chronaxie, wherein the delivered electrical stimulation is configured to inhibit contraction of at least one a bladder or bowel of the patient.

Sacral nerve stimulation

Acoustic signals may be used to monitor one or more symptoms of a patient disease. A patient prescription may indicate one or more acoustic sensing programs that may be used to monitor at least on characteristic of an acoustic signal indicative of a patient symptom or disease. The patient prescription may also include a patient specific threshold. When the at least one characteristic of the acoustic signal is compared to the patient specific threshold an indication or warning signal may be generated. The warning signal may indicate a change in patient disease state.

Acoustic monitoring to detect medical condition

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.

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Plymouth, MN, United States of America

Xin Su