SHIFTING BETWEEN ELECTRODE COMBINATIONS IN ELECTRICAL STIMULATION DEVICE

• US 20090228070A1
• Filed: 02/25/2009
• Published: 09/10/2009
• Est. Priority Date: 04/11/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: `King, Gary W., Goetz, Steven M., Lee, Michael T., Heruth, Kenneth T., Testerman, Roy L., Torgerson, Nathan A., Keacher, Jeffrey T., Houchins, Andrew H., Nolan, Joseph J.
• Granted Patent: US 7,957,814 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data

Abstract

The disclosure is directed to techniques for shifting between two electrode combinations. An amplitude of a first electrode combination is incrementally decreased while an amplitude of a second, or subsequent, electrode combination is concurrently incrementally increased. Alternatively, an amplitude of the first electrode combination is maintained at a target amplitude level while the amplitude of the second electrode combination is incrementally increased. The stimulation pulses of the electrode combinations are delivered to the patient interleaved in time. In this manner, the invention provides for a smooth, gradual shift from a first electrode combination to a second electrode combination, allowing the patient to maintain a continual perception of stimulation. The shifting techniques described herein may be used during programming to shift between different electrode combinations to find an efficacious electrode combination. Additionally, the techniques may be used for shifting between different electrode combinations associated with different stimulation programs or program sets.

Claims

1. A system comprising:

a medical device that includes;

one or more electrodes,

a stimulation generator to deliver electrical stimulation via the electrodes, and

a switch device to couple the stimulation to selected electrodes; and

a programmer that programs the medical device, wherein the programmer controls the medical device to;

deliver electrical stimulation to a patient via a first electrode combination,

deliver electrical stimulation to the patient via a second electrode combination on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination,

incrementally increase an amplitude of the electrical stimulation delivered via the second electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination, and

incrementally decrease an amplitude of the electrical stimulation delivered via the first electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination.

2. The system of claim 1, wherein the programmer controls the medical device to maintain an amplitude of the electrical stimulation delivered via the first electrode combination at a target amplitude level while the amplitude of the electrical stimulation delivered via the second electrode combination is incrementally increased.

3. The system of claim 2, wherein the programmer controls the medical device to maintain an amplitude of the electrical stimulation delivered via the second electrode combination at approximately the target amplitude level while the amplitude of the electrical stimulation delivered via the first electrode combination is incrementally decreased.

4. The system of claim 3, wherein the programmer controls the medical device to incrementally decrease the amplitude of the electrical stimulation delivered via the first electrode combination after the amplitude of the electrical stimulation delivered via the second electrode combination has reached the target amplitude level.

5. The system of claim 1, wherein the programmer controls the medical device to incrementally decrease an amplitude of the stimulation delivered via the first electrode combination while the amplitude of the stimulation delivered via the second electrode combination is incrementally increased.

6. The system of claim 5, wherein the programmer controls the medical device to incrementally increase and decrease the amplitudes in response to user input.

7. The system of claim 1, wherein one of the programmer and the medical device monitors the amplitude of the stimulation delivered via the second electrode combination, and the medical device shuts off the stimulation delivered via the first electrode combination when the amplitude of the stimulation applied to the second electrode combination reaches a target amplitude level.

8. The system of claim 1, wherein one of the programmer and the medical device monitors the amplitude of the stimulation delivered via the second electrode combination, and the medical device incrementally decreases the stimulation delivered via the first electrode combination after the amplitude of the stimulation applied to the second electrode combination reaches the target amplitude level.

9. The system of claim 1, wherein the programmer receives input from the user to adjust an overall intensity of the stimulation delivered via the first and second electrode combinations, and controls the medical device to adjust the overall intensity, wherein adjusting the overall intensity of the stimulation delivered to the first and second electrode combinations comprises adjusting at least one of an amplitude of the stimulation delivered to the first electrode combination, an amplitude of the stimulation delivered to the second electrode combination, a target amplitude level, and a perception amplitude level of stimulation delivered to a third electrode combination.

10. The system of claim 1, wherein the programmer controls the medical device to shift the delivery of stimulation among a predefined sequence of electrode combinations in response to time-domain input from a user.

11. The system of claim 10, wherein the time-domain input includes actuation of control inputs including play, rewind, stop and fast-forward inputs.

12. The system of claim 1, wherein the medical device includes an implantable medical device that delivers the electrical stimulation to the first and second electrode combinations via one or more implantable leads.

13. The system of claim 1, wherein the programmer controls the medical device to deliver electrical stimulation on a time-interleaved basis by delivering electrical stimulation pulses via the first electrode combination and the second electrode combination on an alternating, pulse-by-pulse basis.

14. The system of claim 1, wherein the programmer controls the medical device to deliver electrical stimulation on a time-interleaved basis by delivering multiple electrical stimulation pulses via the first electrode combination in a series of first time slots and delivering multiple electrical stimulation pulses via the second electrode combination in a series of second time slots different from the first time slots.

15. The system of claim 1, wherein the medical device is an implantable device.

16. A medical device comprising:

one or more implantable leads that include a plurality of electrodes;

a stimulation generator to deliver stimulation energy;

a switch device to couple the stimulation energy to selected electrodes; and

a processor to control the stimulation generator and the switch device to deliver stimulation to the patient in accordance with a plurality of programs, wherein the processor controls the stimulation generator and the switch device to;

deliver electrical stimulation to a patient via a first electrode combination,

deliver electrical stimulation to the patient via a second electrode combination on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination,

incrementally increase an amplitude of the electrical stimulation delivered via the second electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination, and

incrementally decrease an amplitude of the electrical stimulation delivered via the first electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination.

17. The device of claim 16, wherein the processor controls the stimulation generator to maintain an amplitude of the electrical stimulation delivered via the first electrode combination at a target amplitude level while the amplitude of the electrical stimulation delivered via the second electrode combination is incrementally increased.

18. The device of claim 16, wherein the processor controls the stimulation generator to maintain an amplitude of the electrical stimulation delivered via the second electrode combination at approximately the target amplitude level while the amplitude of the electrical stimulation delivered via the first electrode combination is incrementally decreased.

19. The device of claim 18, wherein the processor controls the stimulation generator to incrementally decrease the amplitude of the electrical stimulation delivered via the first electrode combination after the amplitude of the electrical stimulation delivered via the second electrode combination has reached the target amplitude level.

20. The device of claim 16, wherein the processor controls the stimulation generator to incrementally decrease an amplitude of the stimulation delivered via the first electrode combination while the amplitude of the stimulation delivered via the second electrode combination is incrementally increased.

21. The device of claim 16, wherein the processor monitors the amplitude of the stimulation delivered via the second electrode combination, and controls the stimulation generator to shut off the stimulation delivered via the first electrode combination when the amplitude of the stimulation applied to the second electrode combination reaches a target amplitude level.

22. The device of claim 16, wherein the processor monitors the amplitude of the stimulation delivered via the second electrode combination, and controls the stimulation generator incrementally decreases the stimulation delivered via the first electrode combination after the amplitude of the stimulation applied to the second electrode combination reaches the target amplitude level.

23. The device of claim 16, wherein the processor controls the stimulation generator to deliver electrical stimulation on a time-interleaved basis by delivering electrical stimulation pulses via the first electrode combination and the second electrode combination on an alternating, pulse-by-pulse basis.

24. The device of claim 16, wherein the processor controls the stimulation generator to deliver electrical stimulation on a time-interleaved basis by delivering multiple electrical stimulation pulses via the first electrode combination in a series of first time slots and delivering multiple electrical stimulation pulses via the second electrode combination in a series of second time slots different from the first time slots.

25. The device of claim 16, wherein the medical device is an implantable device.

26. A programmer comprising:

a processor that generates instructions to control an implantable stimulation generator device to deliver stimulation to a patient in accordance with a plurality of programs, wherein the instructions direct;

delivery of electrical stimulation to a patient via a first electrode combination,

delivery of electrical stimulation to the patient via a second electrode combination on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination,

incremental increases in an amplitude of the electrical stimulation delivered via the second electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination, and

incremental decreases in an amplitude of the electrical stimulation delivered via the first electrode combination while the electrical stimulation delivered via the second electrode combination is delivered on a time-interleaved basis with the electrical stimulation delivered via the first electrode combination; and

a telemetry interface to transmit the instructions to the implantable stimulation generator device.

29. The programmer of claim 26, wherein the processor controls delivery of the electrical stimulation via the implantable stimulation generator and one or more implantable leads carrying the electrode combinations.

30. The programmer of claim 26, wherein the processor controls incremental shifting of the delivery of stimulation from the first electrode combination to the second electrode combination over a series of time slots.

27. The programmer of 26, further comprising a user interface that receives user input to identify the second electrode combination.

28. The programmer of claim 27, wherein the processor incrementally increases and decreases an amplitude of the electrical stimulation in response to a user input from the user interface.

31. A system comprising:

an medical device that includes;

one or more implantable leads that include a plurality of electrodes;

a stimulation generator to deliver electrical stimulation; and

a switch device to couple the stimulation to selected electrodes; and

a programmer that programs the medical device, wherein the programmer controls the medical device to deliver electrical stimulation to a patient via a first electrode combination, deliver electrical stimulation to the patient via a second electrode combination on a time-interleaved basis with the stimulation delivered via the first electrode combination, and incrementally shift the delivery of stimulation from the first electrode combination to the second electrode combination.

32. A medical device comprising:

one or more implantable leads that include a plurality of electrodes;

a stimulation generator to deliver stimulation energy;

a switch device to couple the stimulation energy to selected electrodes; and

a processor to control the stimulation generator and the switch device to deliver stimulation to the patient in accordance with a plurality of programs, wherein the processor controls the stimulation generator and the switch device to deliver stimulation to the patient via a first electrode combination and to deliver electrical stimulation to the patient via a second electrode combination on a time-interleaved basis with the stimulation delivered via the first electrode combination, and wherein the processor incrementally shifts the delivery of stimulation from the first electrode combination to the second electrode combination.