Techniques for delivering electrical stimulation therapy comprising a complex variation to at least one electrical stimulation parameter are described. In one example, processing circuitry of an implantable medical device (IMD) identifies a plurality of electrical stimulation parameters for at least one pulse train of electrical stimulation. The processing circuitry defines a complex variation to at least one electrical stimulation parameter of the plurality of electrical stimulation parameters. The processing circuitry modifies the at least one pulse train of electrical stimulation by introducing the complex variation to the electrical stimulation parameter function and controls a stimulation generator of the IMD to generate, as modified, the at least one pulse train of electrical stimulation.

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may be configured to deliver electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of therapy pulses at a predetermined pulse frequency over a period of time and deliver, over the period of time, a plurality of control pulses interleaved with at least some therapy pulses of the plurality of therapy pulses. The system may also be configured to sense, after one or more control pulses and prior to an immediately subsequent therapy pulse of the plurality of therapy pulses, a respective evoked compound action potential (ECAP), adjust, based on at least one respective ECAP, one or more parameter values that at least partially defines the plurality of therapy pulses, and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

The disclosure describes a method and system that allows a user to configure electrical stimulation therapy by defining a three-dimensional (3D) stimulation field. After a stimulation lead is implanted in a patient, a clinician manipulates the 3D stimulation field in a 3D environment to encompass desired anatomical regions of the patient. In this manner, the clinician determines which anatomical regions to stimulate, and the system generates the necessary stimulation parameters. In some cases, a lead icon representing the implanted lead is displayed to show the clinician where the lead is relative to the 3D anatomical regions of the patient.

Apparatuses and methods of using them for setting a therapeutic dose of a neuromodulator implanted into a patient are described. The methods and apparatuses described herein may include determining the dose based on a patient-specific database of previously delivered dose parameters and corresponding pre-delivery and post-delivery pain estimates from the patient.

An implantable medical device (IMD) includes multiple stimulation engines for independently stimulating respective electrode sets of a lead system while avoiding collisions and/or channel contention during stimulation delivery. A first voltage multiplier is configured to generate an adjustable target voltage having sufficient headroom at an output node that is commonly coupled to anodic nodes of respective stimulation engines. Each stimulation engine includes a secondary voltage multiplier to drive the respective anode and a current regulator powered by a floating voltage supply, wherein the current regulator is coupled to a cathodic node and configured to control how much stimulation current is pulled from the patient tissue.

The present disclosure provides systems and methods relating to neuromodulation. In particular, the present disclosure provides systems and methods for eliminating the onset response when blocking nerve conduction. The various embodiments disclosed herein include methods for designing waveforms that block nerve conduction without inducing an onset response, and systems for delivering treatment based on these waveforms to subjects with pathological neural activity.

Devices, systems, and techniques for controlling electrical stimulation therapy are described. In one example, a system may be configured to deliver electrical stimulation therapy to a patient, the electrical stimulation therapy comprising a plurality of therapy pulses at a predetermined pulse frequency over a period of time and deliver, over the period of time, a plurality of control pulses interleaved with at least some therapy pulses of the plurality of therapy pulses. The system may also be configured to sense, after one or more control pulses and prior to an immediately subsequent therapy pulse of the plurality of therapy pulses, a respective evoked compound action potential (ECAP), adjust, based on at least one respective ECAP, one or more parameter values that at least partially defines the plurality of therapy pulses, and deliver the electrical stimulation therapy to the patient according to the adjusted one or more parameter values.

Systems and methods are disclosed for managing a tissue node potential of a neurostimulation system. The envisioned neurostimulation system can include an energy source, a housing or a housing portion, a stimulation node, a stimulation surface for contacting a tissue of a patient, and a control circuit. The control circuit can be configured to maintain at least one of the housing or housing portion, the stimulation node, or the stimulation surface at a predefined voltage or within a predefined voltage range.

Methods and devices are provided for activating brown adipose tissue (BAT). Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss. In one embodiment, a medical device is provided that activates BAT by electrically stimulating nerves that activate the BAT and/or electrically stimulating brown adipocytes directly, thereby increasing thermogenesis in the BAT and inducing weight loss through energy expenditure.

A method of treating cardiovascular disease in a patient includes generating, by an implantable stimulator configured to be implanted beneath a skin surface of the patient, stimulation sessions at a duty cycle that is less than 0.05 and applying, by the implantable stimulator in accordance with the duty cycle, the stimulation sessions to a location, within the patient, that is associated with the cardiovascular disease. The duty cycle is a ratio of T3 to T4. Each stimulation session included in the stimulation sessions has a duration of T3 minutes and occurs at a rate of once every T4 minutes.