This application is generally related to identifying or otherwise programming one or more cycling parameters for operation of an implantable pulse generator to provide a neurostimulation therapy to a patient using a non-paresthesia stimulation pattern. In some embodiments, the cycling parameter is selected by measuring physiological signals during trial stimulation. In other embodiments, multiple cycling parameters are identified for use by the patient using a patient controller device.

Provided herein is a method of blocking a nerve or neuron by applying an electrical stimulation to the nerve or neuron, wherein the electrical stimulation is of an intensity below the excitation threshold of the nerve or neuron for a length of time sufficient to produce a block of nerve conduction or neuron excitation.

The present disclosure provides systems and methods for an output architecture for an implantable pulse generator of a neurostimulation system. The output architecture includes a power supply, a plurality of outputs, a global source current regulator coupled to the power supply and operable to source current from the power supply to the plurality of outputs through a plurality of source current branches, a global sink current regulator operable to sink current from the plurality of outputs to ground through a plurality of sink current branches, a current source branch selector operable to select, for each of the plurality of outputs, an amount of current sourced from the plurality of source current branches, and a current sink branch selector operable to select, for each of the plurality of outputs, an amount of current sunk to the plurality of sink current branches.

An example of a system for delivering neurostimulation energy may include a programming control circuit and a user interface. The programming control circuit may be configured to generate stimulation parameters according to a neurostimulation program including a pattern of interferential stimulation configured to effect asynchronous and/or non-regular activation of nerve fibers by simultaneously delivering a first stimulation current having a first waveform with a first frequency using a first electrode configuration and a second stimulation current having a second waveform with a second frequency using a second electrode configuration. The user interface may be configured to determine the neurostimulation program and to provide the pattern of interferential stimulation with modulation of the first waveform, the second waveform, the first electrode configuration, and/or the second electrode configuration to result in a time-varying beat frequency capable of effecting the asynchronous and/or non-regular activation of the nerve fibers.

Methods and systems for obtaining and analyzing electromyography responses of electrodes of an implanted neurostimulation lead for use neurostimulation programming are provided herein. System setups for neural localization and/or programming include a clinician programmer coupleable with a temporary or permanent lead implantable in a patient and at least one pair of EMG sensing electrodes minimally invasively positioned on a skin surface or within the patient. The clinician programmer is configured to determine a plurality of recommended electrode configurations based on thresholds and EMG responses of the plurality of electrodes and rank the electrode configuration according to pre-determined criteria. The clinician programmer further includes graphical user interface on which the plurality of recommended electrode configurations are displayed for modification and/or selection by a clinician in programming an IPG or EPG coupled with the lead to apply a neurostimulation treatment according to the selected electrode configuration.

Systems and methods for identifying and treating patients with high frequency electrical signals. A representative method for identifying a patient as a candidate for pain treatment includes identifying a first sensory threshold, delivering an electrical signal to a neural population of the patient at a frequency in a frequency range of 1.5 kHz to 100 kHz and, while and/or after delivering the electrical signal to the patient, identifying a second sensory threshold of the patient. If the second sensory threshold is less than the first, the method can include identifying the patient as a candidate for receiving an electrical signal at a frequency in the foregoing range for pain treatment.

Multi-phasic fields are produced at a neuromodulation site using electrodes. A first phase is directed at a target region such that a first-polarity electrical charge is injected to the target region, and a second phase is directed at portions of the neuromodulation site other than the target region, such that a second-polarity electrical charge opposite the first-polarity electrical charge is injected to those portions of the neuromodulation site to essentially neutralize the first-polarity charge injected at the neuromodulation site while maintaining at least a portion of the first-polarity charge at the target region. In some embodiments, each anode used to produce the first phase is used as a cathode to produce the second phase, and each cathode used to produce the first phase is used as an anode to produce the second phase, and the quantity of charge injected by each electrode in both phases is essentially zero.

Systems and methods for treating a patient having acute decompensated heart failure (ADHF) using electrical stimulation are disclosed. A representative method for treating a patient includes positioning an implantable signal delivery device proximate to a target location at or near the patient's spinal cord within a vertebral range of about T1 to about T12, directing an electrical therapy signal to the target location via the implantable signal delivery device, wherein the electrical signal has a frequency in a frequency range of from 1.2 kHz to 100 kHz to modulate one or more of the patient's sympathetic nerves and treat the patient's ADHF.

Selective high-frequency spinal chord modulation for inhibiting pain with reduced side affects and associated systems and methods are disclosed. In particular embodiments, high-frequency modulation in the range of from about 1.5 KHz to about 50 KHz may be applied to the patient's spinal chord region to address low back pain without creating unwanted sensory and/or motor side affects. In other embodiments, modulation in accordance with similar parameters can be applied to other spinal or peripheral locations to address other indications.

Methods and systems for testing and treating spinal cord stimulation (SCS) patients are disclosed. Patients are eventually treated with sub-perception (paresthesia free) therapy. However, supra-perception stimulation is used during sweet spot searching during which active electrodes are selected for the patient. This allows sweet spot searching to occur much more quickly and without the need to wash in the various electrode combinations that are tried. After selecting electrodes using supra-perception therapy, therapy is titrated to sub-perception levels using the selected electrodes. Such sub-perception therapy has been investigated using pulses at or below 10 kHz, and it has been determined that a statistically significant correlation exists between pulse width (PW) and frequency (F) in this frequency range at which SCS patients experience significant reduction in symptoms such as back pain. Beneficially, sub-perception stimulation at such low frequencies significantly lowers power consumption in the patient's neurostimulator.