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61.发明授权公开(公告)号：US09937342B2
公开(公告)日：2018-04-10
申请号：US12110906
申请日：2008-04-28
申请人： Dennis M. Skelton , Joseph J. Nolan , Nathan A. Torgerson , Wende L. Dewing , Todd V. Smith , Shyam Gokaldas , Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher
发明人： Dennis M. Skelton , Joseph J. Nolan , Nathan A. Torgerson , Wende L. Dewing , Todd V. Smith , Shyam Gokaldas , Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher
CPC分类号： A61N1/0553 , A61N1/0531 , A61N1/0534 , A61N1/37247
摘要： The disclosure provides techniques for parameter-directed shifting of electrical stimulation electrode combinations. An external programmer permits a user to shift electrode combinations, e.g., along the length of a lead or leads. The external programmer accepts shift input and causes an electrical stimulator to shift electrode combinations as indicated by the input. Different sets of electrodes may have different electrode counts. For example, an array of electrodes carried by one lead may have a greater number of electrodes than an array of electrodes carried on another lead. The disclosure provides techniques for shifting electrode combinations among leads with different electrode counts. For example, an external programmer may execute shifts in a series of shift operations, where the number of shift operations along the length of a lead having a greater electrode count is greater than the number of shift steps along the length of a lead having a lesser electrode count.
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公开(公告)号：US09320901B2
公开(公告)日：2016-04-26
申请号：US12769149
申请日：2010-04-28
CPC分类号： A61N1/36082 , A61N1/08 , A61N1/36071
摘要： This disclosure describes techniques that support delivering electrical stimulation current via at least two user-selected electrodes of an implantable medical device (IMD) and automatically delivering balancing current below via at least one non-selected electrode. Balancing currents delivered via the at least one non-selected electrode may be configured with an amplitude below a perception threshold of a patient. Delivery of balancing current via the at least one third electrode may allow an implantable medical device to automatically balance the total current delivered to a patient.
摘要翻译： 本公开描述了支持通过可植入医疗装置（IMD）的至少两个用户选择的电极传递电刺激电流并且经由至少一个未选择的电极自动递送平衡电流的技术。 经由至少一个未选择的电极传送的平衡电流可以被配置为具有低于患者感知阈值的幅度。 通过至少一个第三电极传送平衡电流可以允许可植入医疗装置自动平衡递送给患者的总电流。
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公开(公告)号：US09259587B2
公开(公告)日：2016-02-16
申请号：US13152870
申请日：2011-06-03
申请人： Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Gary W. King , Kenneth T. Heruth , Roy L. Testerman , Michael T. Lee , Nathan A. Torgerson , Joseph J. Nolan
发明人： Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Gary W. King , Kenneth T. Heruth , Roy L. Testerman , Michael T. Lee , Nathan A. Torgerson , Joseph J. Nolan
CPC分类号： A61N1/37247 , A61N1/36071 , A61N1/36185 , A61N1/37252
摘要： The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination. Additionally, the techniques may be used for shifting between different electrode combinations associated with different stimulation programs or program sets.
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64.发明授权公开(公告)号：US08751007B2
公开(公告)日：2014-06-10
申请号：US13251911
申请日：2011-10-03
申请人： Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Gary W. King , Kenneth T. Heruth , Roy L. Testerman , Michael T. Lee , Nathan A. Torgerson , Joseph J. Nolan
发明人： Steven M. Goetz , Andrew H. Houchins , Jeffrey T. Keacher , Gary W. King , Kenneth T. Heruth , Roy L. Testerman , Michael T. Lee , Nathan A. Torgerson , Joseph J. Nolan
CPC分类号： A61N1/37247 , A61N1/36071 , A61N1/36185 , A61N1/37252
摘要： The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination. Additionally, the techniques may be used for shifting between different electrode combinations associated with different stimulation programs or program sets.
摘要翻译： 本公开涉及用于在两个电极组合之间移位的技术。 第一电极组合的振幅逐渐减小，而第二或随后的电极组合的振幅同时递增地增加。 或者，第一电极组合的振幅保持在目标振幅水平，而第二电极组合的振幅逐渐增加。 电极组合的刺激脉冲在时间上交付给患者。 以这种方式，本发明提供从第一电极组合到第二电极组合的平滑，逐渐的移动，允许患者保持连续的刺激感知。 本文描述的移位技术可以在编程期间用于在不同电极组合之间移动以找到有效的电极组合。 另外，这些技术可用于在与不同刺激程序或程序集相关联的不同电极组合之间进行移位。
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公开(公告)号：US08744591B2
公开(公告)日：2014-06-03
申请号：US12771652
申请日：2010-04-30
申请人： Jon P. Davis , Steven M. Goetz , Nathan A. Torgerson , Wende L. Dewing , Ashish Singal , Lynn A. Davenport , Rajeev M. Sahasrabudhe , Brent A. Huhta
发明人： Jon P. Davis , Steven M. Goetz , Nathan A. Torgerson , Wende L. Dewing , Ashish Singal , Lynn A. Davenport , Rajeev M. Sahasrabudhe , Brent A. Huhta
IPC分类号： A61N1/08
CPC分类号： A61N1/37247 , A61N1/372 , A61N1/37211 , A61N1/37264
摘要： This disclosure describes techniques for obtaining an image of an anatomical implant region where leads associated with an implantable medical device are implanted in a patient, manipulating the image to show lead locations and placements, performing necessary image compression and manipulations, adjusting the image to associate it with information (e.g., patient, metadata, annotations, etc.) useful to a subsequent programmer retrieving the image, and transferring a copy of the captured image to the implantable medical device. The image stored in the implantable medical device may be retrieved at a later time by a user of programmer, where the user can use the image and other associated information to program subsequent therapy.
摘要翻译： 本公开描述了用于获得解剖植入区域的图像的技术，其中与植入式医疗装置相关联的引线植入患者体内，操纵图像以显示引导位置和放置，执行必要的图像压缩和操作，调整图像以使其相关联 具有对随后的程序员检索图像有用的信息（例如，患者，元数据，注释等），以及将捕获的图像的副本传送到可植入医疗装置。 存储在可植入医疗装置中的图像可以在稍后由编程器的用户检索，其中用户可以使用图像和其他相关信息来编程后续治疗。
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66.发明授权公开(公告)号：US08571677B2
公开(公告)日：2013-10-29
申请号：US12696992
申请日：2010-01-29
IPC分类号： A61N1/00
CPC分类号： A61N1/0531 , A61N1/0534 , A61N1/0551 , A61N1/0553 , A61N1/37247
摘要： This disclosure describes techniques that support delivering electrical stimulation via an electrode on a housing of an implantable medical device (IMD) while substantially simultaneously delivering electrical stimulation via one or more electrodes, having the same polarity as the electrode on the housing, on one or more leads engaged to the IMD. The stimulation may be constant current-based or constant voltage-based stimulation in the form of pulses or continuous waveforms. Delivery of stimulation via both a housing anode and one or more lead anodes, for example, may allow a user to control current paths between the housing electrode and the lead electrode(s) in a relative manner to achieve different electric or stimulation field shapes.
摘要翻译： 本公开描述了支持通过可植入医疗装置（IMD）的壳体上的电极传送电刺激的技术，同时基本上同时通过一个或多个电极（其具有与壳体上的电极相同的极性）在一个或多个 领导从事IMD。 刺激可以是以脉冲或连续波形的形式的恒定的基于电流或恒定电压的刺激。 例如，通过壳体阳极和一个或多个引线阳极传送刺激可允许用户以相对的方式控制外壳电极和引线电极之间的电流路径，以实现不同的电场或刺激场的形状。
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公开(公告)号：US08543202B2
公开(公告)日：2013-09-24
申请号：US12829089
申请日：2010-07-01
IPC分类号： A61N1/05
CPC分类号： A61N1/3605 , A61N1/0534 , A61N1/0553 , A61N1/36017 , A61N1/36025 , A61N1/37247
摘要： This disclosure describes delivery of omnipolar electrical stimulation with an external electrical stimulator. Omnipolar electrical stimulation may involve stimulation with an electrode carried on the housing of an implantable medical device (IMD) while substantially simultaneously delivering stimulation via one or more implanted electrodes having the same polarity as the electrode on the housing. An external medical device (EMD) may simulate the IMD housing electrode with an electrode separate from the electrodes carried on leads implanted near target tissue. This electrode may be an external electrode carried on the external housing of the EMD or an external patch electrode. Alternatively, the electrode may be an implantable electrode coupled to the EMD. The conductivity of the external or implantable electrode may also be optimized to approximate the conductivity of the IMD housing electrode. This electrode coupled to the EMD may be utilized during trial stimulation or chronic, external, stimulation.
摘要翻译： 本公开描述了用外部电刺激器递送全极电刺激。 全极性电刺激可涉及利用携带在可植入医疗装置（IMD）的壳体上的电极进行刺激，同时通过一个或多个与壳体上的电极极性相同的注入电极输送刺激。 外部医疗设备（EMD）可以模拟IMD外壳电极，其中电极与植入靶组织附近的导线上携带的电极分开。 该电极可以是承载在EMD的外壳上的外部电极或外部贴片电极。 或者，电极可以是耦合到EMD的可植入电极。 外部或可植入电极的导电性也可以被优化以接近IMD外壳电极的导电性。 耦合到EMD的该电极可以在试验刺激或慢性，外部刺激期间使用。
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68.发明授权公开(公告)号：US08219196B2
公开(公告)日：2012-07-10
申请号：US12362167
申请日：2009-01-29
申请人： Nathan A. Torgerson
发明人： Nathan A. Torgerson
IPC分类号： A61N1/00
CPC分类号： G01R31/3693 , A61N1/0531 , A61N1/0534 , A61N1/36082 , A61N1/37258 , A61N1/378
摘要： Techniques for determining whether a medical device will be able to deliver stimulation according to a particular program throughout a useable voltage range of a power source of the medical device are described. According to some examples, the medical device configures a DC to DC converter of the medical device in a specified output configuration and delivers electrical stimulation from the medical device according to a program while at the specified output configuration. Whether the medical device will be able to deliver stimulation according to the program when the power source is at a power source voltage level lower than a present voltage level used during therapy delivery is determined based on a value of a voltage drop across a regulator module determined while delivering the electrical stimulation according to the program. The determination for a program may be performed, as an example, when the program is created or modified.
摘要翻译： 描述了用于确定医疗设备是否能够根据特定程序在医疗设备的电源的可用电压范围内递送刺激的技术。 根据一些示例，医疗设备以指定的输出配置配置医疗设备的DC-DC转换器，并且在指定的输出配置下，根据程序从医疗设备传送电刺激。 基于在确定的调节器模块上的电压降的值来确定当电源处于低于治疗期间使用的当前电压电平的电源电压电平时，医疗装置是否能够根据程序传送刺激 同时根据程序传递电刺激。 作为示例，可以执行程序的确定，当创建或修改程序时。
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公开(公告)号：US20120078325A1
公开(公告)日：2012-03-29
申请号：US13310136
申请日：2011-12-02
IPC分类号： A61N1/372
CPC分类号： A61N1/37247 , A61N1/36082 , A61N1/36185 , Y10S128/903
摘要： A programmer allows a clinician to identify combinations of electrodes from within an electrode set implanted in a patient that enable delivery of desirable neurostimulation therapy by an implantable medical device. The programmer executes an electrode combination search algorithm to select combinations of electrodes to test in a non-random order. According to algorithms consistent with the invention, the programmer may first identify a position of a first cathode for subsequent combinations, and then select electrodes from the set to test with the first cathode as anodes or additional cathodes based on the proximity of the electrodes to the first cathode. The programmer may store information for each combination tested, and the information may facilitate the identification of desirable electrode combinations by the clinician. The clinician may create neurostimulation therapy programs that include identified desirable program combinations.
摘要翻译： 程序员允许临床医生从植入在患者体内的电极组中识别电极的组合，其能够通过可植入医疗装置递送所需的神经刺激疗法。 编程器执行电极组合搜索算法以选择电极的组合以非随机顺序进行测试。 根据与本发明一致的算法，程序员可以首先识别用于后续组合的第一阴极的位置，然后基于电极与电极的接近度，从第一阴极中选择电极作为阳极或附加阴极进行测试 第一阴极。 程序员可以存储每个测试组合的信息，并且该信息可以有助于由临床医生识别期望的电极组合。 临床医生可以创建神经刺激治疗程序，其包括所识别的期望程序组合。
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公开(公告)号：US20110093047A1
公开(公告)日：2011-04-21
申请号：US12771652
申请日：2010-04-30
申请人： Jon P. Davis , Steven M. Goetz , Nathan A. Torgerson , Wende L. Dewing , Ashish Singal , Lynn A. Davenport , Rajeev M. Sahasrabudhe , Brent A. Huhta
发明人： Jon P. Davis , Steven M. Goetz , Nathan A. Torgerson , Wende L. Dewing , Ashish Singal , Lynn A. Davenport , Rajeev M. Sahasrabudhe , Brent A. Huhta
IPC分类号： A61N1/08
CPC分类号： A61N1/37247 , A61N1/372 , A61N1/37211 , A61N1/37264
摘要： This disclosure describes techniques for obtaining an image of an anatomical implant region where leads associated with an implantable medical device are implanted in a patient, manipulating the image to show lead locations and placements, performing necessary image compression and manipulations, adjusting the image to associate it with information (e.g., patient, metadata, annotations, etc.) useful to a subsequent programmer retrieving the image, and transferring a copy of the captured image to the implantable medical device. The image stored in the implantable medical device may be retrieved at a later time by a user of programmer, where the user can use the image and other associated information to program subsequent therapy.
摘要翻译： 本公开描述了用于获得解剖植入区域的图像的技术，其中与植入式医疗装置相关联的引线植入患者体内，操纵图像以显示引导位置和放置，执行必要的图像压缩和操作，调整图像以使其相关联 具有对随后的程序员检索图像有用的信息（例如，患者，元数据，注释等），以及将捕获的图像的副本传送到可植入医疗装置。 存储在可植入医疗装置中的图像可以在稍后由编程器的用户检索，其中用户可以使用图像和其他相关信息来编程后续治疗。
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