An introducing device for locating a tissue region and deploying an electrode is shown and described. The introducing device may include an outer sheath. An inner sheath may be disposed within the outer sheath. The inner sheath may be configured to engage an implantable electrode. In an example, the inner sheath may comprise a stimulation probe having an uninsulated portion at or near a distal end of the delivery sheath. The outer sheath may be coupled to a power source or stimulation signal generating circuitry at a proximal end. A clinician may control application of the stimulation signal to a tissue region via the outer sheath.

Systems of techniques for controlling charge flow during the electrical stimulation of tissue. In one aspect, a method includes receiving a charge setting describing an amount of charge that is to flow during a stimulation pulse that electrically stimulates a tissue, and generating and delivering the stimulation pulse in a manner such that an amount of charge delivered to the tissue during the stimulation pulse accords with the charge setting.

A neural stimulus comprises at least three stimulus components, each comprising at least one of a temporal stimulus phase and a spatial stimulus pole. A first stimulus component delivers a first charge which is unequal to a third charge delivered by a third stimulus component, and the first charge and third charge are selected so as to give rise to reduced artefact at recording electrodes. In turn this may be exploited to independently control a correlation delay of a vector detector and an artefact vector to be non-parallel or orthogonal.

A cochlear implant system may include a cochlear implant configured to be implanted within a user and a sound processor configured to detect an amount of sound exposure to the user; gradually adjust a most comfortable level (“M level”) from an initial value towards a target value in accordance with an adaption time course and in accordance with the detected amount of sound exposure to the user by increasing the M level when the detected amount of sound exposure is above a first threshold and decreasing the M level when the detected amount of sound exposure is below a second threshold; and direct the cochlear implant to apply stimulation having the gradually adjusted M level to the user.

Devices and methods for improving device therapy such as cardiac resynchronization therapy by determining a value for a device parameter are described. An ambulatory medical device (AMD) can include a sensor circuit to sense a physiological signal and generate two or more signal metrics, and detect an event of worsening cardiac condition using the two or more signal metrics. In response to the detection of worsening cardiac condition, the AMD can determine, for a stimulator, a value of at least one stimulation parameter based on temporal responses of two or more signal metrics. The temporal responses include near-term and long-term responses to the stimulation. The AMD can program the stimulator with the determined parameter value, and generate stimulation according to the determined parameter value to stimulate target tissue.

Techniques for determining the trajectory of a one or more dorsal roots and utilizing the trajectories to improve a spinal cord stimulation model are disclosed. A first improvement constructs a target stimulation field along a path that is parallel with the determined trajectory that is nearest to a specified desired location of stimulation. An allocation of stimulation among the electrodes to mimic the target field is computed. A second improvement models a response of neural elements at evaluation positions that are parallel with the trajectories based on the electric field that is generated for the computed allocation of stimulation among the electrodes. The stimulation amplitude is adjusted based on the neural element modeling to maintain stimulation intensity, and the stimulation amplitude and allocation of stimulation among the electrodes are compiled into an electrode configuration that is communicated to a neurostimulator.

A method for implanting a lead includes inserting a needle into the patient; inserting a lead blank through the needle; steering the lead blank to, or near, a lead implantation site; removing the needle from the patient and leaving the lead blank; advancing a flexible sheath over the lead blank after removing the needle; removing the lead blank from the patient and leaving the flexible sheath; inserting a lead through the flexible sheath, after removing the lead blank, and implanting the lead at the lead implantation site; and removing the flexible sheath. The flexible sheath can also be used for explanting a lead and, optionally, implanting a new lead.

In one embodiment, a method of programming an implantable medical device (IMD) to provide therapeutic operations for a patient, comprises: conducting a first communication session between the IMD with an external programming device when network connectivity for a remote server for medical device management is not available for the external programming device; receiving programming data by the IMD from the external programming device to provide therapeutic operations according to at least one instance of settings data during the first communication session, wherein the at least one instance of settings data is validated by a temporary key; conducting a second communication session between the IMD with an external device when network connectivity to the remote server for medical device management is available for the external device; and replacing validation data signed using the temporary key with the received validation data.

In one embodiment, a method of programming an implantable medical device (IMD) to provide therapeutic operations for a patient, comprises: receiving first programming data by the IMD from the external programming device to provide therapeutic operations according to at least one instance of settings data during a first communication session; receiving second programming data by the IMD from the external programming device to define limitations of reprogramming during one or more subsequent offline programming sessions; conducting a second communication session between the IMD with an external programming device when network connectivity is not available; receiving third programming data by IMD from the external programming device to provide therapeutic operations according to at least one instance of settings data during the second communication session; and determining whether the third programming data is permitted according to limitations defined by the second programming data.

Transducer-based systems can be configured to display a graphical representation of a transducer-based device, the graphical representation including graphical elements corresponding to transducers of the transducer-based device, and also including between graphical elements respectively associated with a set of the transducers and respectively associated with a region of space between the transducers of the transducer-based device. Selection of graphical elements and/or between graphical elements can cause activation of the set of transducers associated with the selected elements. Selection of a plurality of graphical elements and/or between graphical elements can cause visual display of a corresponding activation path in the graphical representation. Visual characteristics of graphical elements and between graphical elements can change based on an activation-status of the corresponding transducers. Activation requests for a set of transducers can be denied if it is determined that a transducer in the set of transducers is unacceptable for activation.