An electrode arrangement for stimulating and recording electrical signals in biological matter comprises: an array (110) of electrodes (112), wherein electrodes (112) are configured to be switchable between stimulating and recording of electrical signals; a control unit (120), wherein the control unit (120) is configured to select a plurality of electrodes (112) to form a combined macroelectrode site (114) for providing a stimulating signal, wherein the control unit (120) is further configured to determine a perimeter electrode (112b) and a central electrode (112a), wherein the perimeter electrode (112b) is arranged at a perimeter of the combined macroelectrode site (114) and the central electrode (112a) is arranged centrally within the combined macroelectrode site (114), and wherein the control unit (120) is further configured to provide a stimulation signal to the perimeter electrode (112b) that has a lower magnitude than a stimulation signal provided to the central electrode (112a).

In an embodiment herein, an aortopulmonary stimulation method is provided including positioning at least one aortic electrode in or near the aorta, and using the at least one aortic electrode, to deliver stimulation to the aorta to decrease aortic after load.

An example medical device includes a plurality of electrodes, therapy delivery circuitry, and processing circuitry configured to control the therapy delivery circuitry to deliver electrical stimulation to an intercostal nerve of a patient via at least two of the plurality of electrodes, wherein the electrical stimulation is delivered with stimulation parameters configured to suppress ventricular tachyarrhythmia of the patient, wherein the stimulation parameters comprise a stimulation frequency less than or equal to 40 hertz (Hz).

Devices and methods are provided to treat acute and chronic heart failure by using one or more implantable or non-implantable sensors along with phrenic nerve stimulation to reduce intrathoracic pressure and thereby reduce pulmonary artery, atrial, and ventricular pressures leading to reduced complications and hospitalization.

A control module for an electrical stimulation system includes a sealed electronics housing; an electronic subassembly disposed within the electronics housing; one or more connector assemblies coupled to the electronic subassembly; and a rechargeable battery disposed external to the electronics housing. The one or more connector assemblies are configured to receive a lead. The rechargeable battery includes a positive electrode, a negative electrode, and a single battery case attached directly to the sealed electronics housing and forming a sealed cavity that encapsulates both the positive electrode and the negative electrode. The battery case is electrically isolated from each of the positive electrode and the battery electrode.

Devices, systems and methods provide forms of asymptomatic diaphragmatic stimulation (ADS) therapy that affect pressures within the intrathoracic cavity, including: 1) dual-pulse ADS therapy, during which a first ADS pulse is delivered during a diastolic phase of a cardiac cycle and a second ADS pulse is delivered during a systolic phase, 2) paired-pulse ADS therapy, during which a first ADS pulse is delivered, closely followed by a second ADS pulse, with the second ADS pulse functioning to extend or enhance a phase of a transient, partial contraction of the diaphragm, and 3) multiple-pulse ADS therapy, during which a stream of ADS pulses is delivered, wherein the time between pulses is based on heart rate. Devices, systems and methods also monitor electromyography (EMG) activity of the diaphragm relative to baseline activity to assess the health of a diaphragm subject to ADS therapy and to adjust ADS therapy parameters or sensing parameters.

Examples disclosed herein are relevant to testing capacitors to identify potentially faulty DC blocking capacitors in implantable stimulators. In an example, the test includes selecting an active electrode, a return electrode, and a reference electrode. Short duration monophasic stimulation is used to charge up the DC blocking capacitors of the active and return electrodes. The electrodes are subsequently disconnected from all other nodes except a discharge circuit (e.g., a star circuit) and the tissue. The reference electrode is used to measure the voltage of the DC blocking capacitor of the active electrode during the charging phase and the discharging phase (via the discharge circuit). The characteristics of one or more of the capacitors charging or discharging can be sensed and then analyzed to determine whether the one or more capacitors are functioning properly. Faulty capacitors can be identified by comparing actual and expected characteristics.

Systems and methods for creating, maintaining, and remotely modifying stimulation settings for a neuromodulation therapy are discussed. An exemplary system includes an implantable stimulator to provide electrostimulation via a lead comprising a plurality of electrodes, and a programming device. The programming device identifies a search space of electrode configurations and parameter values for the lead, and determines, based on a clinical response indicator under a first patient state, at least one base stimulation setting including an optimal electrode configuration and an optimal stimulation parameter value from the identified search space. The system includes a remotely controlled therapy titration device that can modify the base stimulation setting under a second patient state based on an evaluation of a modified clinical response indicator. The modified base stimulation setting may be stored in the memory, or used by the implantable stimulator to deliver electrostimulation.

A system may include a stimulator, sensing circuitry and a controller. The stimulator may be operably connected to at least one stimulation electrode, and configured to deliver an electrical waveform for an electrical therapy using the at least one stimulation electrode. The sensing circuitry may be operably connected to at least one sensing electrode, and configured to sense electrical potentials that are evoked by the electrical waveform to provide sensed evoked signals. The controller may be operably connected to the stimulator and the sensing circuitry. The controller may be configured to automatically define a sampling window, sample the sensed evoked potentials during the sampling window to provide sampled values, detect at least one feature from the sampled values, and automatically provide feedback for closed-loop control of the electrical therapy based on the at least one feature.

A stimulation system may include a sensor configured to detect a physiological signal of a user, the physiological signal having a biomarker therein associated with a disorder of the user; a stimulator configured to deliver electrical stimulation to the user; and a hub device configured to receive the physiological signal from the sensor and to output a control signal to the stimulator. The control signal may cause the stimulator to deliver electrical stimulation to the user according to a stimulation protocol, the stimulation protocol treating the disorder. The hub device may be configured to output the control signal based on the biomarker of the received physiological signal. The hub device may be configured to generate another control signal for treating another disorder based on a biomarker not included in the physiological signal received from the sensor.