Devices and methods of use for introduction and implantation of an electrode as part of a minimally invasive technique. An implantable baroreflex activation system includes a control system having an implantable housing, an electrical lead, attachable to the control system, and an electrode structure. The electrode structure is near one end of the electrical lead, and includes a monopolar electrode, a backing material having an effective surface area larger than the electrode, and a releasable pivotable interface to mate with an implant tool. The electrode is configured for implantation on an outer surface of a blood vessel and the control system is programmed to deliver a baroreflex therapy via the monopolar electrode to a baroreceptor within a wall of the blood vessel.

A method for implanting a neurostimulation lead within a patient includes measuring impedances of electrodes on the lead in order to correctly position the lead relative to a target tissue region. The electrodes are circumferentially segmented electrodes that are spaced from each other about the longitudinal axis of the lead. When the difference between the impedances of the electrodes exceeds a threshold value, the lead is in the correct position. In accordance with another embodiment, impedance measurements are used to select which one of the electrodes is closest to the target tissue region. By determining which electrode has the highest impedance and which electrode has the lowest impedance, the type of tissue adjacent to each electrode can be determined based on the conductivity properties of the tissue. The target tissue region may be a spinal cord, a posterior longitudinal ligament, white matter, or gray matter.

A neuromodulation system and method with feedback optimized electrical field generation for stimulating target tissue of a patient to treat neurological and non-neurological conditions. The system generally includes implantable electrodes, implantable sensors, an implantable or external electrical signal generator, and an implantable or external controller. The controller controls the electrical signal generator to generate electrical noise stimulation signals that are delivered to the target tissue via the electrodes and that produce an optimized electric field having maximized voltage with low current density. The sensors produce temperature and impedance data for the target tissue and the controller automatically responds to values of the sensor data that indicate potential damage to the target tissue to reduce the strength of the electric field.

In some examples, a processor of a system evaluates a therapy program based on a score determined based on a volume of tissue expected to be activated (“VTA”) by therapy delivery according to the therapy program. The score may be determined using a three-dimensional (3D) grid comprising a plurality of voxels that are each assigned a value. The processor may register the VTA with the 3D grid and determine the score for the therapy program based on the values assigned to voxels with which the VTA overlaps. One or more therapy programs for electrical stimulation therapy (e.g., deep brain stimulation) may be selected based on the scores determined based on the 3D grid.

A system for adjusting neuromodulation parameters used by a neuromodulator operably connected to a plurality of electrodes to modulate a neural target, may comprise a translation trigger detector configured to determine that a translation trigger has occurred, a first parameter setting storage configured to store first parameter settings for use by the neuromodulator to modulate the neural target, and a neuromodulation parameter translator. The neuromodulation parameter translator may be operably connected to the translation trigger detector to automatically translate the first parameter settings into a second parameter settings in response to determining the translation trigger has occurred, and replace the first parameter settings with the second parameter settings, or store the second parameter settings in a second parameter setting storage. Automatically translating may include either automatically translating from cathodic parameter settings to anodic parameter settings, or automatically translating from anodic parameter settings to cathodic parameter settings.

This disclosure describes implantable medical leads and medical device systems utilizing the leads. In some examples, an implantable medical lead comprises a first defibrillation electrode and a second defibrillation electrode, the first and second defibrillation electrodes configured to deliver anti-tachyarrhythmia shocks, and a pace electrode disposed between the first defibrillation electrode and the second defibrillation electrode, the pace electrode configured to deliver a pacing pulse that generates an electric field proximate to the pace electrode. The implantable medical lead further comprises a shield disposed between the first defibrillation electrode and the second defibrillation electrode and over a portion of an outer surface of the pace electrode, wherein the shield is configured to impede the electric field in a direction from the pace electrode away from a heart.

Disclosed is a computer-implemented medical data processing method for planning a position of an electric stimulation device for neurostimulation of at least two target regions (TV1, . . . , TVN) disposed in an anatomical body part of a patient's body, the electric stimulation device (7) comprising at least two electric contacts, the method comprising executing, on at least one processor of at least one computer (3), steps of: a) acquiring (S1.1), at the at least one processor, medical image data describing a digital image of the anatomical body part, wherein the anatomical body part contains at least two target regions (TV1, . . . , TVN); b) determining (S1.2), by the at least one processor and based on the medical image data, target position data describing a position of each target region (TV1, . . . , TVN) in the anatomical body part; c) acquiring (S1.3), at the at least one processor, electric stimulation device geometry data describing a distance between the at least two contacts of the electric stimulation device (7); d) determining (S1.4), by the at least one processor and based on the target position data, target distance data describing a distance between each pair of the at least two target regions; e) determining (S1.5), by the at least one processor and based on the target position data and the target distance data and the electric stimulation device geometry data, electric stimulation device position data describing a stimulation position which is a relative position between the at least two target regions (TV1, . . . , TVN) and the electric stimulation device (7) which allows for stimulation of the at least two target regions (TV1, . . . , TVN) by the electric stimulation device (7).

A planning and/or control system for providing stimulation is disclosed. The system can include a graphical presentation module configured and arranged for providing graphical information about an electrode array comprising multiple electrodes and/or an implantation side for the electrode array comprising at least one target area, a selection module configured and arranged for determining a stimulation zone and/or a stimulation direction on the electrode array comprising at least one electrode and/or for individually selecting at least one electrode and/or for selecting at least one target area, and a calculation module configured and arranged for determining a contribution of currents provided by electrodes of the stimulation zone and/or stimulation direction on the electrode array and/or the at least one electrode selected and/or to the at least one target area selected.

A planning and/or control system for a system for providing neuromodulation, especially neurostimulation, at least comprising: a graphical presentation module configured and arranged for providing graphical information about an electrode array comprising multiple electrodes and/or an implantation side for the electrode array comprising at least one target area, a selection module configured and arranged for determining a stimulation zone and/or a stimulation direction on the electrode array comprising at least one electrode and/or for individually selecting at least one electrode and/or for selecting at least one target area, a calculation module configured and arranged for determining a contribution of currents provided by electrodes of the stimulation zone and/or stimulation direction on the electrode array and/or the at least one electrode selected and/or to the at least one target area selected.

A catheter may include electrodes for transvascular nerve stimulation. The electrodes may be positioned within lumens of the catheter and aligned with apertures in the outer wall of the catheter. The electrodes may produce focused electrical fields for stimulation of one or more nerves. In one embodiment, the catheter may include a set of proximal electrodes and a set of distal electrodes, and the proximal electrodes may stimulate a patient's left phrenic nerve and the distal electrodes may stimulate a patient's right phrenic nerve.