A neurostimulation system comprises a control system configured to monitor a patient receiving neurostimulation therapy. The neurostimulation therapy has a stimulation cycle comprising a stimulation ON period, in which the patient is receiving neurostimulation, and a stimulation OFF period, in which the patient is not receiving neurostimulation. The control system is programmed to receive electrocardiogram (ECG) data from the patient receiving the neurostimulation therapy. The control system is further programmed to monitor a heart rate of the patient based on the ECG data over at least one stimulation cycle of the neurostimulation therapy. The control system is further programmed to generate an indication of signal stability to be displayed to a user based on the received ECG data.

A system for collecting real-time on-demand measurements. The system includes an implantable sensor that has a power source, a sensing circuit, a communications circuit, a memory, and one or more processors. The sensing circuit senses a physiologic parameter of interest (PPOI) and generates signals indicative of the PPOI. The communications circuit communicates with at least one of an implantable medical device (IMD) or an external device (ED). The one or more processors execute program instructions stored in the memory to collect real-time on-demand measurements by activating the sensing circuit to generate the signals indicative of the PPOI, converting the signals to physiologic data indicative of the PPOI, storing the physiologic data in the memory, and directing the communications circuit to transmit the physiologic data to the at least one of the IMD or the ED.

An implantable medical device (IMD) has a housing enclosing an electronic circuit. The housing includes a first housing portion, a second housing portion and a joint coupling the first housing portion to the second housing portion. A polymer seal is positioned in the joint in various embodiments. Other embodiments of an IMD housing are disclosed.

Systems and methods for promoting neuroplasticity in a brain of a subject to improve and/or restore neural function are disclosed herein. One such method includes detecting residual movement and/or muscular activity in a limb of the subject, such as a paretic limb. The method further includes generating a stimulation pattern based on the detected movement and/or muscular activity, and stimulating the brain of the subject with the stimulation pattern. It is expected that delivering stimulation based on the detected residual movement and/or muscular activity of the limb will induce neuroplasticity for restoring neural function, such as control of the limb. A second method involves detecting brain signals and delivering contingent stimulation. A third method involves delivering pairs of successive stimulus patterns to two brain sites, controlled either by preprogrammed sequences or contingent on neural or muscular activity or movement.

A system may include a neuromodulator and a processing system. The neuromodulator may be configured to be programmed with a set of more than one program to deliver neuromodulation. The processing system may be configured to: receive sensed data indicative of activity, motion and/or posture of a patient; analyze the activity, motion and/or posture of the patient; and perform a process, based on the analyzed activity, motion and/or posture, for switching from one program in the set of more than one program to another program from the set of more than one program. The process may include automatically implementing the other program from the set of more than one program or suggesting to switch to the other program from the set of more than one program.

A method of optimally placing spinal cord stimulator (SCS) leads includes acquiring components of somatosensory evoked potentials (SSEPs), compound action potentials and triggered EMG; analyzing the waveforms; and quantifying waveform features in a single display such that a surgeon can quickly and easily determine optimal placement (as it relates to laterality and level of placement on the spinal cord) of SCS leads in a patient under general anesthesia without additional expert help.

An electrode lead comprises an electrically insulative cuff body and at least three axially aligned electrode contacts circumferentially disposed along the inner surface of the cuff body when in the furled state. The electrode contacts may be circumferentially disposed around a nerve, and an electrical pulse train may be delivered to the electrode contacts thereby stimulating the nerve to treat obstructive sleep apnea. The electrical pulse train may be one that pre-conditions peripherally located nerve fascicles to not be stimulated, while stimulating centrally located nerve fascicles. A feedback mechanism can be used to titrate electrode contacts and electrical pulse train to the patient. A sensor that is affixed to the case of a neurostimulator can be used to measure physiological artifacts of respiration, and a motion detector can be used to sense tapping of the neurostimulator to toggle the neurostimulator between an ON position and an OFF position.

A system and/or method to control operation of an implantable medical device in response to sensed occurrence of a designated physical action intentionally performed by the patient.

Techniques are disclosed for implementing the use of electrically evoked compound action potentials (ECAPs) to adaptively adjust parameters of high frequency electrical stimulation. In one example, a medical device delivers electrical stimulation therapy comprising a train of electrical stimulation pulses to a patient, wherein the train of electrical stimulation pulses comprises a pulse frequency greater than or equal to 500 Hertz. After delivering the train of electrical stimulation pulses, the medical device ceases delivery of the high frequency electrical stimulation therapy for a predetermined period of time. During the predetermined period of time, the medical device senses an ECAP from the patient and determines, based on the sensed ECAP, a value of a parameter at least partially defining the train of electrical stimulation pulses. Responsive to the predetermined period of time elapsing, the medical device resumes delivery of the high frequency electrical stimulation according to the determined parameter.

Systems and methods for closed-loop control of electrostimulation while avoiding, or maintaining a substantially low level of, evoked neural activity are disclosed. A system comprises an electrostimulator to deliver a stimulation pulse train, a sensing circuit to sense evoked responses to respective pulses in the pulse train, and a controller to detect an evoked neural activity from an averaged evoked response by averaging evoked responses to respective pulses. The averaging operation can be controlled by a noise level of the averaged evoked response, or by a count of epochs (pulses) being used for averaging. Responsive to the evoked neural activity satisfying a detection criterion, the controller recursively adjusts stimulation parameters until the detection criterion is no longer satisfied. The electrostimulator delivers electrostimulation according to the recursively adjusted stimulation parameters.