公开(公告)号：US09814395B2

公开(公告)日：2017-11-14

申请号：US13568887

申请日：2012-08-07

申请人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

发明人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

IPC分类号： A61B5/02 ,  A61B5/00 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/053 ,  A61B5/107

CPC分类号： A61B5/02007 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1076 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/6876 ,  A61B5/6877 ,  A61B5/7203 ,  A61B5/7275

摘要： Implanted electrodes can be used to deliver electrical stimulation signals to areas near blood vessels, nerves, or other internal body locations. In an example, an electrode can be implanted in a cervical location and can be used to measure dimensional changes in an artery using impedance plethysmography. Measured artery dimensional changes can be used to determine one or more physiological parameters associated with a patient's health status, such as pulse transit time, relative pulse pressure, or aterial compliance, among others. These parameters can be used to monitor a patient health status or to modulate a patient's therapy, among other uses. In some examples, an electrode configured to deliver an electrostimulation signal to nerve tissue can be used to provide non-neurostimulating electrical stimulation plethysmography signals near a blood vessel.

公开(公告)号：US20130041269A1

公开(公告)日：2013-02-14

申请号：US13568887

申请日：2012-08-07

申请人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

发明人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

IPC分类号： A61B5/0205 ,  A61N1/36 ,  A61B5/08 ,  A61B5/11 ,  A61B5/024 ,  A61B5/05 ,  A61B5/021

CPC分类号： A61B5/02007 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1076 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/6876 ,  A61B5/6877 ,  A61B5/7203 ,  A61B5/7275

摘要： Implanted electrodes can be used to deliver electrical stimulation signals to areas near blood vessels, nerves, or other internal body locations. In an example, an electrode can be implanted in a cervical location and can be used to measure dimensional changes in an artery using impedance plethysmography. Measured artery dimensional changes can be used to determine one or more physiological parameters associated with a patient's health status, such as pulse transit time, relative pulse pressure, or aterial compliance, among others. These parameters can be used to monitor a patient health status or to modulate a patient's therapy, among other uses. In some examples, an electrode configured to deliver an electrostimulation signal to nerve tissue can be used to provide non-neurostimulating electrical stimulation plethysmography signals near a blood vessel.

摘要翻译： 可以使用植入电极将电刺激信号传送到血管，神经或其他内部身体位置附近的区域。 在一个实例中，电极可以植入颈部位置，并可用于使用阻抗体积描记法测量动脉的尺寸变化。 测量的动脉尺寸变化可以用于确定与患者的健康状况相关联的一个或多个生理参数，例如脉搏传播时间，相对脉压或全身依从性等。 这些参数可用于监测患者的健康状况或调节患者的治疗以及其他用途。 在一些示例中，可以使用构造成将神经刺激信号传递给神经组织的电极，以在血管附近提供非神经刺激电刺激体积描记信号。

公开(公告)号：US20120271382A1

公开(公告)日：2012-10-25

申请号：US13453279

申请日：2012-04-23

申请人： Shantha Arcot-Krishnamurthy ,  Stephen Ruble ,  Jason J. Hamann ,  Juan Gabriel Hincapie Ordonez ,  David J. Ternes

发明人： Shantha Arcot-Krishnamurthy ,  Stephen Ruble ,  Jason J. Hamann ,  Juan Gabriel Hincapie Ordonez ,  David J. Ternes

IPC分类号： A61N1/36

CPC分类号： A61N1/36185 ,  A61N1/36053 ,  A61N1/3611 ,  A61N1/36132 ,  A61N1/36135

摘要： Some embodiments provide a method, comprising performing a neural stimulation test routine for stimulating a neural target in a cervical region of a patient, wherein for each of a plurality of head positions, performing the neural stimulation test routine includes testing a plurality of electrode configurations. The method further comprises recording threshold data for each of the tested electrode configurations for the plurality of head positions, and recommending an electrode configuration based on the recorded threshold data.

摘要翻译： 一些实施例提供了一种方法，包括执行用于刺激患者的子宫颈区域中的神经靶标的神经刺激测试程序，其中对于多个头部位置中的每一个，执行神经刺激测试程序包括测试多个电极配置。 该方法还包括记录针对多个头部位置的每个测试电极配置的阈值数据，以及基于记录的阈值数据推荐电极配置。

公开(公告)号：US20130053926A1

公开(公告)日：2013-02-28

申请号：US13586432

申请日：2012-08-15

申请人： Juan Gabriel Hincapie Ordonez ,  Stephen J. Hahn ,  David J. Ternes ,  Shantha Arcot-Krishnamurthy ,  Jason J. Hamann

发明人： Juan Gabriel Hincapie Ordonez ,  Stephen J. Hahn ,  David J. Ternes ,  Shantha Arcot-Krishnamurthy ,  Jason J. Hamann

IPC分类号： A61N1/36

CPC分类号： A61B5/0492 ,  A61B5/0488 ,  A61B5/4035 ,  A61N1/0556 ,  A61N1/36053 ,  A61N1/36114

摘要： Some embodiments provide a system for delivering neurostimulation. Some system embodiments comprise a lead configured to be implanted in the body, a stimulation output circuit configured to deliver neurostimulation pulses to the vagus nerve through the lead, an EMG sensing circuit configured to use the lead to sense EMG signals from laryngeal muscle activity, and an evoked muscular response detection circuit configured to use the EMG signals sensed by the EMG sensing circuit to detect evoked laryngeal muscle activity evoked by the neurostimulation pulse.

摘要翻译： 一些实施例提供用于递送神经刺激的系统。 一些系统实施例包括被配置为植入体内的引线，刺激输出电路，其经配置以通过引线将神经刺激脉冲输送到迷走神经; EMG感测电路，被配置为使用引线来感测来自喉部肌肉活动的EMG信号;以及 诱发肌肉反应检测电路，被配置为使用由EMG感测电路感测的EMG信号来检测由神经刺激脉冲诱发的诱发喉部肌肉活动。

公开(公告)号：US20110313488A1

公开(公告)日：2011-12-22

申请号：US13155549

申请日：2011-06-08

申请人： Juan Gabriel Hincapie Ordonez ,  Stephen Ruble ,  Jason J. Hamann ,  Eric A. Mokelke ,  Shantha Arcot-Krishnamurthy ,  Kevin John Stalsberg ,  David J. Ternes

发明人： Juan Gabriel Hincapie Ordonez ,  Stephen Ruble ,  Jason J. Hamann ,  Eric A. Mokelke ,  Shantha Arcot-Krishnamurthy ,  Kevin John Stalsberg ,  David J. Ternes

IPC分类号： A61N1/36

CPC分类号： A61N1/36142 ,  A61N1/36114 ,  A61N1/36139 ,  A61N1/36146

摘要： Various neural stimulator embodiments comprise controller circuitry, neural stimulation output circuitry, sensor circuitry and a memory. The neural stimulation output circuitry is configured to deliver the neural stimulation. The controller circuitry is configured to control stimulation parameters of the neural stimulation delivered by the neural stimulation output circuitry. The sensor circuitry, including at least one sensor, is configured to sense a response to the neural stimulation. The controller is configured to communicate with the sensor circuitry. The memory has instructions stored therein, operable on by the controller circuitry. The instructions include instructions for delivering neural stimulation using the neural stimulation output circuitry, instructions for controlling a titration sweep wherein the titration sweep varies stimulation parameter values, and instructions for monitoring a response to the titration sweep and automatically selecting stimulation parameters that provide an efficacious neural stimulation and provide a desirable safety margin to prevent injury to neural tissue.

摘要翻译： 各种神经刺激器实施例包括控制器电路，神经刺激输出电路，传感器电路和存储器。 神经刺激输出电路被配置为递送神经刺激。 控制器电路被配置为控制由神经刺激输出电路传递的神经刺激的刺激参数。 包括至少一个传感器的传感器电路被配置为感测对神经刺激的响应。 控制器被配置为与传感器电路通信。 存储器具有存储在其中的指令，可由控制器电路操作。 说明书包括使用神经刺激输出电路递送神经刺激的指令，用于控制滴定扫描的指令，其中滴定扫描改变刺激参数值，以及用于监测对滴定扫描的响应的指令，并自动选择提供有效神经元的刺激参数 刺激并提供理想的安全余量以防止对神经组织的损伤。

公开(公告)号：US08594805B2

公开(公告)日：2013-11-26

申请号：US13586432

申请日：2012-08-15

申请人： Juan Gabriel Hincapie Ordonez ,  Stephen J. Hahn ,  David J. Ternes ,  Shantha Arcot-Krishnamurthy ,  Jason J. Hamann

发明人： Juan Gabriel Hincapie Ordonez ,  Stephen J. Hahn ,  David J. Ternes ,  Shantha Arcot-Krishnamurthy ,  Jason J. Hamann

IPC分类号： A61N1/00

CPC分类号： A61B5/0492 ,  A61B5/0488 ,  A61B5/4035 ,  A61N1/0556 ,  A61N1/36053 ,  A61N1/36114

摘要： Some embodiments provide a system for delivering neurostimulation. Some system embodiments comprise a lead configured to be implanted in the body, a stimulation output circuit configured to deliver neurostimulation pulses to the vagus nerve through the lead, an EMG sensing circuit configured to use the lead to sense EMG signals from laryngeal muscle activity, and an evoked muscular response detection circuit configured to use the EMG signals sensed by the EMG sensing circuit to detect evoked laryngeal muscle activity evoked by the neurostimulation pulse.

摘要翻译： 一些实施例提供用于递送神经刺激的系统。 一些系统实施例包括被配置为植入体内的引线，刺激输出电路，其经配置以通过引线将神经刺激脉冲输送到迷走神经; EMG感测电路，被配置为使用引线来感测来自喉部肌肉活动的EMG信号;以及 诱发肌肉反应检测电路，被配置为使用由EMG感测电路感测的EMG信号来检测由神经刺激脉冲诱发的诱发喉部肌肉活动。

公开(公告)号：US20120065702A1

公开(公告)日：2012-03-15

申请号：US13220423

申请日：2011-08-29

申请人： Shantha Arcot-Krishnamurthy ,  David J. Ternes ,  Jason Hamann ,  Juan Gabriel Hincapie Ordonez ,  Stephen Ruble

发明人： Shantha Arcot-Krishnamurthy ,  David J. Ternes ,  Jason Hamann ,  Juan Gabriel Hincapie Ordonez ,  Stephen Ruble

IPC分类号： A61N1/36 ,  A61N1/372

CPC分类号： A61N1/36139 ,  A61N1/36053 ,  A61N1/36128 ,  A61N1/36146 ,  A61N1/36185 ,  A61N1/37235 ,  A61N1/37288

摘要： A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity.

摘要翻译： 神经刺激系统包括神经刺激引线，其具有近端部分和远端部分，并且沿着远端部分包括多个电极。 多个电极被配置用于定位在自主神经系统的一部分附近。 耦合到多个电极的神经刺激电路将神经刺激脉冲传送到多个电极。 处理器和控制器被配置为控制神经刺激电路将第一神经刺激脉冲传送到多个电极配置中的每一个。 每个电极配置包括多个电极中的一个或多个。 所述处理器和控制器进一步被配置为接收与响应于所述第一神经刺激脉冲传送到所述多个电极配置中的每一个而被诱发的电动机纤维活动相关的信息，并且识别诱导所述电机纤维活性的电极配置。

公开(公告)号：US09314627B2

公开(公告)日：2016-04-19

申请号：US13453279

申请日：2012-04-23

申请人： Shantha Arcot-Krishnamurthy ,  Stephen Ruble ,  Jason J. Hamann ,  Juan Gabriel Hincapie Ordonez ,  David J. Ternes

发明人： Shantha Arcot-Krishnamurthy ,  Stephen Ruble ,  Jason J. Hamann ,  Juan Gabriel Hincapie Ordonez ,  David J. Ternes

IPC分类号： A61N1/36

CPC分类号： A61N1/36185 ,  A61N1/36053 ,  A61N1/3611 ,  A61N1/36132 ,  A61N1/36135

摘要： Some embodiments provide a method, comprising performing a neural stimulation test routine for stimulating a neural target in a cervical region of a patient, wherein for each of a plurality of head positions, performing the neural stimulation test routine includes testing a plurality of electrode configurations. The method further comprises recording threshold data for each of the tested electrode configurations for the plurality of head positions, and recommending an electrode configuration based on the recorded threshold data.

摘要翻译： 一些实施例提供了一种方法，包括执行用于刺激患者的子宫颈区域中的神经靶标的神经刺激测试程序，其中对于多个头部位置中的每一个，执行神经刺激测试程序包括测试多个电极配置。 该方法还包括记录针对多个头部位置的每个测试电极配置的阈值数据，以及基于记录的阈值数据推荐电极配置。

公开(公告)号：US08942819B2

公开(公告)日：2015-01-27

申请号：US13155549

申请日：2011-06-08

申请人： Juan Gabriel Hincapie Ordonez ,  Stephen Ruble ,  Jason J. Hamann ,  Eric A. Mokelke ,  Shantha Arcot-Krishnamurthy ,  Kevin John Stalsberg ,  David J. Ternes

发明人： Juan Gabriel Hincapie Ordonez ,  Stephen Ruble ,  Jason J. Hamann ,  Eric A. Mokelke ,  Shantha Arcot-Krishnamurthy ,  Kevin John Stalsberg ,  David J. Ternes

IPC分类号： A61N1/00 ,  A61N1/36

CPC分类号： A61N1/36142 ,  A61N1/36114 ,  A61N1/36139 ,  A61N1/36146

摘要： Various neural stimulator embodiments comprise controller circuitry, neural stimulation output circuitry, sensor circuitry and a memory. The neural stimulation output circuitry is configured to deliver the neural stimulation. The controller circuitry is configured to control stimulation parameters of the neural stimulation delivered by the neural stimulation output circuitry. The sensor circuitry, including at least one sensor, is configured to sense a response to the neural stimulation. The controller is configured to communicate with the sensor circuitry. The memory has instructions stored therein, operable on by the controller circuitry. The instructions include instructions for delivering neural stimulation using the neural stimulation output circuitry, instructions for controlling a titration sweep wherein the titration sweep varies stimulation parameter values, and instructions for monitoring a response to the titration sweep and automatically selecting stimulation parameters that provide an efficacious neural stimulation and provide a desirable safety margin to prevent injury to neural tissue.

摘要翻译： 各种神经刺激器实施例包括控制器电路，神经刺激输出电路，传感器电路和存储器。 神经刺激输出电路被配置为递送神经刺激。 控制器电路被配置为控制由神经刺激输出电路传递的神经刺激的刺激参数。 包括至少一个传感器的传感器电路被配置为感测对神经刺激的响应。 控制器被配置为与传感器电路通信。 存储器具有存储在其中的指令，由控制器电路可操作。 说明书包括使用神经刺激输出电路递送神经刺激的指令，用于控制滴定扫描的指令，其中滴定扫描改变刺激参数值，以及用于监测对滴定扫描的响应的指令，并自动选择提供有效神经元的刺激参数 刺激并提供理想的安全余量以防止对神经组织的损伤。

公开(公告)号：US08452406B2

公开(公告)日：2013-05-28

申请号：US13220423

申请日：2011-08-29

申请人： Shantha Arcot-Krishnamurthy ,  David J. Ternes ,  Jason Hamann ,  Juan Gabriel Hincapie Ordonez ,  Stephen Ruble

发明人： Shantha Arcot-Krishnamurthy ,  David J. Ternes ,  Jason Hamann ,  Juan Gabriel Hincapie Ordonez ,  Stephen Ruble

IPC分类号： A61N1/00

CPC分类号： A61N1/36139 ,  A61N1/36053 ,  A61N1/36128 ,  A61N1/36146 ,  A61N1/36185 ,  A61N1/37235 ,  A61N1/37288

摘要： A neurostimulation system includes a neural stimulation lead having a proximal portion and a distal portion and including a plurality of electrodes along the distal portion. The plurality of electrodes are configured for positioning proximate a portion of the autonomic nervous system. A neural stimulation circuit, coupled to the plurality of electrodes, delivers neural stimulation pulses to the plurality of electrodes. A processor and controller is configured to control the neural stimulation circuit to deliver first neural stimulation pulses to each of a plurality of electrode configurations. Each electrode configuration includes one or more of the plurality of electrodes. The processor and controller is further configured to receive information related to motor fiber activity that is induced in response to delivery of the first neural stimulation pulses to each of the plurality of electrode configurations and to identify the electrode configurations that induce the motor fiber activity.