An implantable vagus nerve stimulation (VNS) system includes a sensor configured to measure ECG data for a patient, a stimulation subsystem configured to deliver VNS to the patient, and a control system configured to perform a heart rate variability analysis with the ECG data. In some aspects, performing the heart rate variability analysis includes measuring R-R intervals between successive R-waves for the ECG data measured during a stimulation period and a baseline period, plotting each R-R interval against an immediately preceding R-R interval for each of the stimulation period and the baseline period, and determining at least one of a standard deviation from an axis of a line perpendicular to an identity line for each of the stimulation period plot and the baseline period plot or a centroid of each of the stimulation period plot and the baseline period plot.

An exemplary electroacupuncture device may be implanted beneath a skin surface of a patient at a location corresponding to a joint affected by osteoarthritis and may perform methods for treating the osteoarthritis. In some implementations, the electroacupuncture device is powered by a primary battery located within the electroacupuncture device and having an internal impedance greater than 5 ohms and a capacity of less than 60 milliamp-hours (mAh).

An example of a system includes a blood pressure modulation device and a controller. The blood pressure modulation device may be configured to deliver a therapy to chronically maintain blood pressure within a prescribed range. The blood pressure modulation device may include a neuromodulator configured to deliver neuromodulation energy to neural tissue in a spinal cord or near the spinal cord using a first parameter set. The controller may include analyzer circuitry configured to determine an actual or anticipated blood pressure demand event indicated for a blood pressure change, and therapy parameter adjuster circuitry configured to respond to the actual or anticipated blood pressure demand event by delivering neuromodulation energy using a second parameter set to change the blood pressure.

Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

A blood pressure controlling apparatus includes an acquiring part configured to acquire biological information indicating blood pressure of a subject, a producing part configured to produce a frequency modulated pulse train on the basis of the biological information, and a supplying part configured to supply an electrical current on the basis of the frequency modulated pulse train, to an electrode attached on the subject. The electrical current stimulates baroreceptor afferent nerves of the subject.

A method of rapid frequency cycling during electrical stimulation according to an embodiment may include determining, by a controller of an electrical stimulation system, a plurality of frequency band groupings of discrete frequency bands of an electrical stimulation signal having a frequency range, wherein each frequency band grouping includes at least one discrete frequency band, wherein a corresponding current or voltage amplitude of the electrical stimulation signal is independently tuned within each discrete frequency band based on feedback received from a patient, determining, by the controller, a random sequence of the frequency band groupings of the plurality of frequency band groupings, generating, by at least one signal generator controlled by the controller, the electrical stimulation signal according to the determined random sequence of the frequency band groupings, and delivering the generated electrical stimulation signal through an electrode array to the patient to provide therapy to the patient.

Recognizing that anodic stimulation may require higher amplitudes or charge than cathodic stimulation in some tissues, new pulsing waveforms for a stimulator device, and particularly useful during monopolar stimulation, are described employing therapeutically-effective anodic and cathodic stimulation pulses at the lead-based electrode(s). The pulses are monophasic, with the amplitude or charge of the anodic monophasic pulses being higher than the cathodic monophasic pulses. To provide charge balance at each electrode, a pulse packet may be defined having a plurality of cathodic monophasic pulses and perhaps only a single anodic monophasic pulse. Because the polarity of cathodic monophasic pulses in each packet may charge balance with the anodic monophasic pulse(s), active charge recovery such as by the use of biphasic pulses may not be necessary, although passive charge recovery can be used if desired.

Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

A user interface of a computing device for programming a medical device configured to review historical user session data while disconnected from the medical device. During a programming session, the user interface on the computing device may include features to control the functionality of the medical device as well as view and manipulate available data stored at the medical device. The user interface may interactively view screens and features and manipulate data using the programming user interface, e.g., as if the external programming device were in a live programming session with the medical device, but while disconnected from the medical device and not in a live programming session. As one example, the user interface of the external programming device may permit flexible, extensive manipulation and viewing of sensed signals, patient events, and operational information, such as patient adjustments made over time or coincident with particular signals or events.

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may include processing circuitry configured to control a medical device to deliver a first electrical stimulation according to a first value of a first stimulation parameter of the plurality of stimulation parameters and a first value of a second parameter of the plurality of stimulation parameters, receive an input representative of an efficacy of the first electrical stimulation delivered to the patient according to the first value of the first stimulation parameter and the first value of the second parameter, select, based on the input and the relationship between the plurality of stimulation parameters, a second value of at least one of the first stimulation parameter or the second stimulation parameter, and control the medical device to deliver a second electrical stimulation according to the second value.