Systems and techniques are disclosed to adjust programming of an implantable electrical neurostimulation device for treating chronic pain of a human subject, through the use of a dynamic model adapted to identify pain treatment parameters for a human patient and determine a best device operational program to implement the pain treatment parameters to address the chronic pain condition. In an example, the system to adjust programming of the neurostimulation device performs operations that: obtain data related to a state of pain of the human subject; identify pain treatment parameters using a dynamic model adapted to evaluate the pain treatment parameters in the human subject over a time period, based on the data related to the state of pain; and select a neurostimulation program for the neurostimulation device, corresponding to at least a portion of the identified pain treatment parameters.

The disclosure provides systems and methods for treating obstructive sleep apnea using an inertial measurement unit (IMU) comprising an accelerometer and a gyroscope, wherein the IMU is configured to detect chest and/or abdominal movement by a patient during the inspiration and expiration stages of a respiratory cycle and to generate positional data based on the detected movement. Positional data generated by the IMU is used by an implanted stimulation system to determine when to deliver electrical stimulation to a nerve which innervates an upper airway muscle, such as the hypoglossal nerve, to treat sleep apnea.

Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. The implanted stimulation device includes a physiological sensor for monitoring the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time and a control system for adjusting stimulation parameters to maintain stimulation in the neural fulcrum zone based on detected changes in the physiological response to stimulation.

The present disclosure provides systems and methods for managing communications in a remote therapy system. A method includes initiating a remote therapy session by establishing communications between a patient device and an implantable medical device implanted in a patient, and establishing communications between the patient device and a clinician device, determining, using the patient device, a distance between the patient and the patient device, comparing, using the patient device, the determined distance to a threshold distance, and managing the communications between the patient device and the implantable medical device based on the comparison.

The invention concerns an arrangement comprising an electrical stimulator (1), a programming system (25) for assisting a user in programming it for performing a determined body movement by neuromuscular stimulation; and an input device (24) operable by the user. The programming system is configured to: decompose the neuromuscular movement into distinct actions (31), select one of them, and configuring the electrical stimulator with the electrical stimulation parameters associated with the selected action. The programming system is further configured to select one electrical stimulation parameter among the electrical stimulation parameters associated with the selected distinct action, and, in a cycle performed while the electrical stimulator is connected to the user's body: to receive a value of the selected electrical stimulation parameter through the input device (24); and to configure the electrical stimulator (1) with the received value of the selected electrical stimulation parameter.

An exemplary cochlear implant system includes a cochlear implant configured to be implanted within a patient and a sound processor. The sound processor is configured to receive, from a fitting system during a fitting session, a command that sets an M level to an initial value and a target value for the M level; gradually adjust, subsequent to the fitting session, the M level from the initial value towards the target value in accordance with an adaption time course; and direct the cochlear implant to apply stimulation having the gradually adjusted M level to the patient. Other systems and methods are also disclosed.

In one embodiment, a method for operating a system for management of implantable medical devices (IMDs), comprises conducting communication sessions with a plurality of clinician programmer devices while the clinician programmer devices are engaged in respective programming sessions with IMDs; receiving and storing second programming data from a plurality of clinician programmer devices, wherein the second programming data was created during programming sessions with IMDs without network connectivity to the system for management of IMDs; reconciling programming of the plurality of IMDs that were programmed with the second programming data with data stored by the system for management of IMDs; and communicating second signed validation data to cause IMDs to conduct therapeutic operations according to programming data validated by respective instances of second validation data.

A neurostimulation system includes a programming control circuit and a user interface. The programming control circuit may be configured to generate a plurality of stimulation parameters controlling delivery of neurostimulation pulses according to one or more neurostimulation programs each specifying a pattern of the neurostimulation pulses. The user interface includes a display screen, a user input device, and a neurostimulation program circuit. The neurostimulation program circuit may be configured to allow for construction of one or more pulse trains (PTs) and one or more train groupings (TGs) of the one or more neurostimulation programs, and to allow for scheduling of delivery of the one or more neurostimulation programs, using the display screen and the user input device. Each PT includes one or more pulse blocks each including a plurality of pulses of the neurostimulation pulses. Each TG includes one or more PTs.

A device, such as an IMD, having a tissue conductance communication (TCC) transmitter controls a drive signal circuit and a polarity switching circuit by a controller of the TCC transmitter to generate an alternating current (AC) ramp on signal having a peak amplitude that is stepped up from a starting peak-to-peak amplitude to an ending peak-to-peak amplitude according to a step increment and step up interval. The TCC transmitter is further controlled to transmit the AC ramp on signal from the drive signal circuit and the polarity switching circuit via a coupling capacitor coupled to a transmitting electrode vector coupleable to the IMD. After the AC ramp on signal, the TCC transmitter transmits at least one TCC signal to a receiving device.

A system may receive first information relating to a patient captured during a baseline period that is prior to the patient receiving stimulation. The system may receive second information relating to the patient captured during an initial therapy assignment. The second information may include testing data generated by delivering stimulation during an implant procedure. The system may determine initial stimulation program settings based on the first information, the second information and population-informed information. The population-informed information may be related to other patients. The system may cause, during a training period, delivery of therapy based on the initial stimulation program settings.