STIMULATION WITH UTILIZATION OF CASE ELECTRODE

• US 20110093042A1
• Filed: 01/29/2010
• Published: 04/21/2011
• Est. Priority Date: 10/21/2009
• Status: Abandoned Application

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Torgerson, Nathan A.
• Application Number:
  US12/696,988
• Publication Number:
  US 20110093042A1
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• 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 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

This disclosure describes techniques that support delivering electrical stimulation via an electrode on a housing of an implantable medical device (IMD) while substantially simultaneously delivering electrical stimulation via one or more electrodes, having the same polarity as the electrode on the housing, on one or more leads engaged to the IMD. The stimulation may be constant current-based or constant voltage-based stimulation in the form of pulses or continuous waveforms. Delivery of stimulation via both a housing anode and one or more lead anodes, for example, may allow a user to control current paths between the housing electrode and the lead electrode(s) in a relative manner to achieve different electric or stimulation field shapes.

Claims

1. A method for delivering electrical stimulation therapy to a patient, the method comprising:

delivering electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD);

delivering electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD; and

delivering, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

2. The method of claim 1, wherein the first electrode, the second electrode, and the third electrode are selected to deliver an overall predetermined summed stimulation current comprising the stimulation current delivered via the first electrode and the second electrode.

3. The method of claim 1, wherein the first electrode is a first anode, and wherein the second electrode is one of a plurality of anodes integral with the lead.

4. The method of claim 3, wherein the lead is a first lead, and wherein the plurality of anodes is a first plurality of anodes, the method further comprising:

delivering electrical stimulation current via one of a second plurality of anodes integral with a second lead substantially simultaneously with the electrical stimulation current delivered via the first anode and the one of a second plurality of anodes.

5. The method of claim 4, further comprising:

delivering electrical stimulation current via at least one cathode on the second lead.

6. The method of claim 1, further comprising:

coupling the first electrode to a first regulated current path to deliver a first amount of the electrical stimulation current;

coupling the second electrode to a second regulated current path to deliver a second amount of the electrical stimulation current; and

coupling the third electrode to a third regulated current path to deliver a third amount of the electrical stimulation current approximately equal to a sum of the first and second amounts of the electrical stimulation current.

7. The method of claim 6, wherein the first amount of the electrical stimulation current is a first regulated source current, the second amount of the electrical stimulation current is a second regulated source current, and the third amount of the electrical stimulation current is a regulated sink current that is approximately equal to a sum of the first and second regulated source currents.

8. The method of claim 1,

wherein the electrical stimulation current delivered by the first electrode is a first stimulation current, wherein the electrical stimulation current delivered by the second electrode is a second stimulation current, and wherein the electrical stimulation current delivered by the third electrode is a third stimulation current, and

wherein the first electrode is coupled to a first regulated voltage source to deliver the first stimulation current, wherein the second electrode is coupled to a second regulated voltage source to deliver the second stimulation current, and wherein the third electrode is coupled to a third voltage source to deliver the third stimulation current.

9. The method of claim 8, wherein the third stimulation current is approximately equal to the sum of the first stimulation current and the second stimulation current.

10. The method of claim 1, wherein the electrical stimulation is selected to provide at least one of deep brain stimulation and spinal cord stimulation.

11. The method of claim 1, further comprising delivering the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is unregulated current;

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

or

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is unregulated current.

12. The method of claim 11, further comprising delivering the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

13. The method of claim 1, wherein the first electrode is a first cathode, and wherein the second electrode is one of a plurality of cathodes integral with the lead.

14. A device for delivering electrical stimulation therapy to a patient, the device comprising:

an implantable housing comprising a first electrode carried by the housing;

one or more leads coupled to the housing;

a second electrode and a third electrode carried by the one or more leads; and

a stimulation generator configured to;

deliver electrical stimulation current with a first polarity via the first electrode;

deliver electrical stimulation current with the first polarity via a second electrode substantially simultaneously with the electrical stimulation current delivered via the first electrode; and

deliver, via the third electrode, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

15. The device of claim 14, wherein the first electrode, the second electrode, and the third electrode are selected to deliver an overall predetermined summed stimulation current comprising the stimulation current delivered via the first electrode and the second electrode.

16. The device of claim 14, wherein the first electrode is a first anode, and wherein the second electrode is one of a plurality of anodes integral with the lead.

17. The device of claim 16, wherein the lead is a first lead, and wherein the plurality of anodes is a first plurality of anodes, the stimulation generator further configured to:

deliver electrical stimulation current via one of a second plurality of anodes integral with a second lead substantially simultaneously with the electrical stimulation current delivered via the first anode and the one of a second plurality of anodes.

18. The device of claim 17, the stimulation generator further configured to:

deliver electrical stimulation current via at least one cathode on the second lead.

19. The device of claim 14, wherein:

the first electrode is coupled to a first regulated current path to deliver a first amount of the electrical stimulation current;

the second electrode is coupled to a second regulated current path to deliver a second amount of the electrical stimulation current; and

the third electrode is coupled to a third regulated current path to deliver a third amount of the electrical stimulation current approximately equal to a sum of the first and second amounts of the electrical stimulation current.

20. The device of claim 19, wherein the first amount of the electrical stimulation current is a first regulated source current, the second amount of the electrical stimulation current is a second regulated source current, and the third amount of the electrical stimulation current is a regulated sink current that is approximately equal to a sum of the first and second regulated source currents.

21. The device of claim 14,

wherein the electrical stimulation current delivered by the first electrode is a first stimulation current, wherein the electrical stimulation current delivered by the second electrode is a second stimulation current, and wherein the electrical stimulation current delivered by the third electrode is a third stimulation current, and

wherein the first electrode is coupled to a first regulated voltage source to deliver the first stimulation current, wherein the second electrode is coupled to a second regulated voltage source to deliver the second stimulation current, and wherein the third electrode is coupled to a third voltage source to deliver the third stimulation current.

22. The device of claim 21, wherein the third stimulation current is approximately equal to the sum of the first stimulation current and the second stimulation current.

23. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

24. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is unregulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

25. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

26. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

27. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

28. The device of claim 14, wherein the stimulation generator is further configured to deliver the electrical stimulation current such that the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is unregulated current, and wherein the stimulation generator is further configured to deliver the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

29. The device of claim 14, wherein the electrical stimulation is selected to provide at least one of deep brain stimulation and spinal cord stimulation.

30. The device of claim 14, wherein the first electrode is a first cathode, and wherein the second electrode is one of a plurality of cathodes integral with the lead.

31. A device for delivering electrical stimulation therapy to a patient, the device comprising:

means for delivering electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD);

means for delivering electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD; and

means for delivering, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

32. A computer-readable storage medium comprising instructions that, when executed by a processor, cause the processor to:

deliver electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD);

deliver electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD; and

deliver, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

33. The computer-readable storage medium of claim 32, wherein the first electrode, the second electrode, and the third electrode are selected to deliver an overall predetermined summed stimulation current comprising the stimulation current delivered via the first electrode and the second electrode.

34. The computer-readable storage medium of claim 32, wherein the first electrode is a first anode, and wherein the second electrode is one of a plurality of anodes integral with the lead.

35. The computer-readable storage medium of claim 34, wherein the lead is a first lead, and wherein the plurality of anodes is a first plurality of anodes, the computer-readable storage medium further comprising instructions that cause the processor to:

deliver electrical stimulation current via one of a second plurality of anodes integral with a second lead substantially simultaneously with the electrical stimulation current delivered via the first anode and the one of a second plurality of anodes.

36. The computer-readable storage medium of claim 35, further comprising instructions that cause the processor to:

deliver electrical stimulation current via at least one cathode on the second lead.

37. The computer-readable storage medium of claim 32, further comprising instructions that cause the processor to:

couple the first electrode to a first regulated current path to deliver a first amount of the electrical stimulation current;

couple the second electrode to a second regulated current path to deliver a second amount of the electrical stimulation current; and

couple the third electrode to a third regulated current path to deliver a third amount of the electrical stimulation current approximately equal to a sum of the first and second amounts of the electrical stimulation current.

38. The computer-readable storage medium of claim 37, wherein the first amount of the electrical stimulation current is a first regulated source current, the second amount of the electrical stimulation current is a second regulated source current, and the third amount of the electrical stimulation current is a regulated sink current that is approximately equal to a sum of the first and second regulated source currents.

39. The computer-readable storage medium of claim 32,

wherein the electrical stimulation current delivered by the first electrode is a first stimulation current, wherein the electrical stimulation current delivered by the second electrode is a second stimulation current, and wherein the electrical stimulation current delivered by the third electrode is a third stimulation current, and

wherein the first electrode is coupled to a first regulated voltage source to deliver the first stimulation current, wherein the second electrode is coupled to a second regulated voltage source to deliver the second stimulation current, and wherein the third electrode is coupled to a third voltage source to deliver the third stimulation current.

40. The computer-readable storage medium of claim 39, wherein the third stimulation current is approximately equal to the sum of the first stimulation current and the second stimulation current.

41. The computer-readable storage medium of claim 32, further comprising instructions for delivering the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is unregulated current;

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is regulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is regulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is regulated current;

or

the electrical stimulation current delivered via the first electrode is unregulated current, the electrical stimulation current delivered via the second electrode is unregulated current, and the electrical stimulation current delivered via the third electrode is unregulated current.

42. The computer-readable storage medium of claim 41, further comprising instructions for delivering the electrical stimulation current such that one of the following applies:

the electrical stimulation current delivered via the first electrode is source current, the electrical stimulation current delivered via the second electrode is source current, and the electrical stimulation current delivered via the third electrode is sink current;

or

the electrical stimulation current delivered via the first electrode is sink current, the electrical stimulation current delivered via the second electrode is sink current, and the electrical stimulation current delivered via the third electrode is source current.

43. The computer-readable storage medium of claim 32, wherein the electrical stimulation is selected to provide at least one of deep brain stimulation and spinal cord stimulation.

44. The computer-readable storage medium of claim 32, wherein the first electrode is a first cathode, and wherein the second electrode is one of a plurality of cathodes integral with the lead.

45. A method for delivering electrical stimulation therapy to a patient, the method comprising:

delivering electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD); and

delivering electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD.

46. The method of claim 45, further comprising:

delivering, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

47. A device for delivering electrical stimulation therapy to a patient, the device comprising:

an implantable housing comprising a first electrode carried by the housing;

one or more leads coupled to the housing;

a second electrode and a third electrode carried by the one or more leads; and

a stimulation generator configured to;

deliver electrical stimulation current with a first polarity via the first electrode; and

deliver electrical stimulation current with the first polarity via a second electrode substantially simultaneously with the electrical stimulation current delivered via the first electrode.

48. The device of claim 47, wherein the stimulation generator is further configured to:

deliver, via the third electrode, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

49. A device for delivering electrical stimulation therapy to a patient, the method comprising:

means for delivering electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD); and

means for delivering electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD.

50. The device of claim 49, further comprising:

means for delivering, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.

51. A computer-readable storage medium comprising instructions that, when executed by a processor, cause the processor to:

deliver electrical stimulation current with a first polarity via a first electrode carried by a housing of an implantable medical device (IMD); and

deliver electrical stimulation current with the first polarity via a second electrode of the IMD substantially simultaneously with the electrical stimulation current delivered via the first electrode, wherein the second electrode is carried by a lead coupled to the IMD.

52. The computer-readable storage medium of claim 51, further comprising instructions that, when executed by a processor, cause the processor to:

deliver, via a third electrode of the IMD, electrical stimulation current with a second polarity opposite the first polarity delivered via the first electrode and the second electrode.