Techniques for sensing neural responses such as Evoked Compound Action Potentials (ECAPs) in an implantable stimulator device are disclosed. A first therapeutic pulse phase is followed by a second pulse phase, which phases may be of opposite polarities to assist with active charge recovery. The second pulse phase is formed so as to overlap in time with the arrival of the ECAP at a sensing electrode, which second phase may generally be longer and of a lower amplitude. In so doing, a stimulation artifact formed in a patient's tissue is rendered constant, and of a smaller amplitude, when the ECAP is sensed at the sensing electrode, which eases sensing by a sense amp circuit. Passive charge recovery may follow the second phase, which will not interfere with ECAP sensing that has already occurred.

One aspect of the present disclosure relates to a system that can prevent unintended signal components (noise) in an electric waveform that can be used for at least one of neural stimulation, block, and/or sensing. The system can include a signal generator to generate a waveform that includes an intended electric waveform and unintended noise. The system can also include a signal transformer device (e.g., a very long wire) comprising a first coil and a second coil. The first coil can be coupled to the signal generator to receive the waveform and remove the unintended noise from the electric waveform. The second coil can pass the electric waveform to an electrode. The second coil can be coupled to a capacitor that can prevent the waveform from developing noise at an electrode/electrolyte interface between an electrode and a nerve.

An electrode element (1) for an energy storage unit (200), such as a capacitor, has an electrode body (100) made of an active electrode material (E), wherein the electrode body (100) includes one or more of: at least one cavity (110) on its surface or in its interior; at least one partial volume (120) of lower density; and/or a surface coating (D) covering at least a portion of the surface of the electrode body (100), such that the surface area covered by the surface coating (D) remains unwetted when in contact with an electrolyte. Energy storage units (200) incorporating the electrode element (1) are particularly suitable for use in implantable electrotherapeutic devices.

Neuromodulation of cranial nerves can be used to treat sleep or breathing disorders, among other diseases and disorders. A neuromodulation system can include a housing configured for implantation in an anterior cervical region of a patient, such as at or under a mandible of the patient, such as at least partially in one or more of a submental triangle, a submandibular triangle, and a carotid triangle. The system can include an electrode lead coupled to the housing, and the electrode lead can include an electrode configured to be disposed at or near a cranial nerve target in the patient. The system can be configured to generate electrical neuromodulation signals for delivery to the cranial nerve target using the electrode.

The present specification discloses devices and methodologies for the treatment of transient lower esophageal sphincter relaxations (tLESRs). Individuals with tLESRs may be treated by implanting a stimulation device within the patient's lower esophageal sphincter and applying electrical stimulation to the patient's lower esophageal sphincter, in accordance with certain predefined protocols. The presently disclosed devices have a simplified design because they do not require sensing systems capable of sensing when a person is engaged in a wet swallow and have improved energy storage requirements.

A neurostimulation system comprising stimulation output circuitry configured for delivering stimulation pulses to target tissue in accordance with a set of stimulation parameters. The neurostimulation system comprises monitoring circuitry configured for continuously measuring action potentials evoked in the target tissue in response to the delivery of the stimulation pulses to the target tissue, memory configured for storing a characteristic of a reference evoked action potential, and at least one processor configured for initiating an automatic mode, in which a characteristic of the measured evoked action potentials is compared to the corresponding characteristic of the reference evoked action potential, and one or more stimulation parameter values in the set of stimulation parameters are adjusted to decrease or increase the energy level of the stimulation pulses, thereby evoking action potentials in the target tissue having substantially the same corresponding characteristic as the reference evoked action potential.

Methods for transcutaneous charging of an implanted device may include removably coupling a charging device with a carrier having adhesive tabs, the tabs being movable between a first position configured to be spaced away from a skin surface and a second position configured to be urged against the skin surface; engaging a bottom surface of the charging device at least partially against the skin surface with the tabs in the first position; positioning the charging device until it is at least partially positioned over or proximate the implanted medical device; and moving the tabs to the second position so that respective adhesive surfaces of the tabs contact and adhere to the skin of the patient sufficiently to support the charging device coupled with the carrier for a duration of time sufficient to charge the implanted device.

Apparatus and methods for stimulating tissue employing local current imbalance to facilitate more effective stimulation regimens.

A device for contacting and/or electrically stimulating biological tissue by means of at least one electrode has at least a first unit, on which the at least one electrode is provided and which is configured for implantation in a human or animal body, a second unit, for supplying the first unit with electrical energy, and at least a first and a second conductive track for the voltage supply of the first unit. The first and second conductive tracks are respectively electrically connected to the first and second units and are at different voltage potentials. Spatially between the first and second conductive tracks, at least a first additional conductive track is arranged that is functionally not involved in the voltage supply of the first unit.

An implantable assembly is described for acquisition of neuronal electrical signals at a selected location which propagate along at least one nerve fiber contained in a nerve fiber bundle, as well as for selective electrical stimulation of the at least one nerve fiber, having: an implantable electrode assembly (E) which is disposed on a biocompatible support substrate which can be positioned around the nerve fiber bundle in a cuff, which has a cylindrical support substrate surface (i) which in the implanted condition is orientated facing the nerve fiber bundle, on which a first electrode assembly for locationally selective acquisition of the neuronal electrical signals and selective electrical stimulation of the at least one nerve fiber, and on which a second electrode assembly is disposed to record an ECG signal, and an analysis and control unit (A/S) which can be electrically conductively connected or is connected to the implantable electrode assembly (E), in which the locationally selective acquired neuronal electrical signals as well as the ECG signal can be analyzed in a time-resolved manner such that a neuronal time signal correlated with a physiological parameter, such as blood pressure, can be derived.