Numerous aspects of communication devices, methods, and systems are described. One aspect is a system comprising an implantable object and at least one energy generator coupled to the implantable object. The at least one energy generator may comprise a plurality of generator elements operable to output a plurality of different energy types in a signal direction toward one or more living tissues of a user. Each generator element of the plurality of generator elements may be independently operable to output one energy type of the plurality of different energy types in the signal direction. When the implantable object is implanted, the at least one energy generator may be operable to affect the one or more living tissues of the user by causing the plurality of generator elements to output an energy signal in the signal direction with one or more energy types of the plurality of different energy types.

A medical device with closed-loop responsive stimulation may include techniques to mitigate the impact on the therapy output of noise coupled into the medical device. A medical device according to this disclosure may determine the presence of noise and alter the closed loop policy to provide the necessary therapy to the patient and avoid prolonged under stimulation caused by the noise. The medical device may continue therapy while testing for noise. When the device determines the noise level no longer affects the output therapy, the device may return the closed loop policy to a no-noise mode of operation. The medical device may also include techniques to mitigate the impact of manual adjustment while the medical device is subject to noise or is responding to changes in the patient's physiological signals.

Provided are devices and methods for preventing an episode of incontinence in an individual in need thereof. The devices comprise a sensor and a stimulator electrode that can be implanted into the body of the individual. Once the device is implanted in the individual, the sensor of the device senses a parameter that is associated with a response from the individual that is intended to prevent an episode of incontinence. Then, the device provides an electrical stimulation using the electrode that, together with the response, helps to prevent the episode of incontinence.

Disclosed includes a body surface device for diagnosing locations associated with electrical rhythm disorders to guide therapy. The device can sense electrical signals and determine multiple sites that may be operative in that patient. The patch may encompass the heart regions from where the heart rhythm disorder originates. The patch comprises an array of electrodes configured to detect electrical signals generated by a heart. A controller may determine the locations of interest based on detected electrical signals. The controller is configured to locate these regions relative to the surface patch. The system may be coupled to a sensor or therapy device inside the heart, to guide this device to a region of interest. The controller is further configured to instruct the operator to use the trigger or source information to treat the heart rhythm disorder in an individual using additional clinical data and methods for personalization such as machine learning.

Disclosed includes a body surface device for diagnosing locations associated with electrical rhythm disorders to guide therapy. The device can sense electrical signals and determine multiple sites that may be operative in that patient. The patch may encompass the heart regions from where the heart rhythm disorder originates. The patch comprises an array of electrodes configured to detect electrical signals generated by a heart. A controller may determine the locations of interest based on detected electrical signals. The controller is configured to locate these regions relative to the surface patch. The system may be coupled to a sensor or therapy device inside the heart, to guide this device to a region of interest. The controller is further configured to instruct the operator to use the trigger or source information to treat the heart rhythm disorder in an individual using additional clinical data and methods for personalization such as machine learning.

Disclosed includes a body surface device for diagnosing locations associated with electrical rhythm disorders to guide therapy. The device can sense electrical signals and determine multiple sites that may be operative in that patient. The patch may encompass the heart regions from where the heart rhythm disorder originates. The patch comprises an array of electrodes configured to detect electrical signals generated by a heart. A controller may determine the locations of interest based on detected electrical signals. The controller is configured to locate these regions relative to the surface patch. The system may be coupled to a sensor or therapy device inside the heart, to guide this device to a region of interest. The controller is further configured to instruct the operator to use the trigger or source information to treat the heart rhythm disorder in an individual using additional clinical data and methods for personalization such as machine learning.

System and methods for monitoring and/or controlling nerve activity in a subject are provided. In one embodiment, a system includes electrodes configured to be placed proximate to a subject's skin, and a signal detector configured to detect electrical signals using the electrodes. The system also includes a signal processor configured to receive the electrical signals to generate filtered signals, the filter configured to attenuate at least signals having frequencies corresponding to heart muscle activity during a heartbeat. The signal processor is also configured to identify a skin nerve activity using the filtered signals, estimate a sympathetic nerve activity using the identified skin nerve activity, and further to generate a report indicative of the estimated sympathetic nerve activity. In some aspects, the system further includes a signal generator to deliver the electrical stimulation to the subject's skin.

Provided are devices and methods for preventing an episode of incontinence in an individual in need thereof. The devices comprise a sensor and a stimulator electrode that can be implanted into the body of the individual. Once the device is implanted in the individual, the sensor of the device senses a parameter that is associated with a response from the individual that is intended to prevent an episode of incontinence. Then, the device provides an electrical stimulation using the electrode that, together with the response, helps to prevent the episode of incontinence.

Stimulation and recording electrode assemblies that are particularly useful for Automatic Period Stimulation (APS). Such embodiments are compatible with nerve monitoring systems to provide continuous stimulation of a nerve during surgery. Certain embodiments include an electrode assembly having cuff including a body and two ears extending from the body. Within the body, at least one electrode is supported and connected to a lead wire assembly. The ears can be brought together to enlarge a gap in the body so that the electrode assembly can be fixated around a nerve. Other embodiments include an electrode assembly including first and second needle electrodes that each have a tip. A body is provided to interconnect the needle electrodes and can be manipulated to move the tips either toward or away from one another. Disclosed embodiments provide nerve monitoring and stimulation in cases where the nerve is only partially dissected.

Automated assessment of neural response recordings involves storing a set of basis functions comprising at least one compound action potential basis function and at least one artefact basis function. Neural recordings of electrical activity in neural tissue are obtained by application of stimuli, using a single configuration of stimulation and recording. Each neural recording is decomposed by determining at least one parameter which estimates at least one of a compound action potential and an artefact. The at least one parameter is/are determined for each respective one of the plurality of neural recordings, to yield a plurality of values. A spread of the plurality of values is determined. An indication that the neural response recordings are of higher quality is output if the spread is small. An indication that the neural response recordings are of lower quality is output if the spread is large.