SHIFTING BETWEEN ELECTRODE COMBINATIONS IN ELECTRICAL STIMULATION DEVICE

• US 20120022614A1
• Filed: 10/03/2011
• Published: 01/26/2012
• Est. Priority Date: 04/11/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Houchins, Andrew H., Keacher, Jeffrey T., King, Gary W., Heruth, Kenneth T., Testerman, Roy L., Lee, Michael T., Torgerson, Nathan A., Nolan, Joseph J.
• Granted Patent: US 8,751,007 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 method comprising:

delivering electrical stimulation to a patient via a first subset of a plurality of electrodes;

delivering electrical stimulation to the patient via a second subset of the electrodes; and

receiving a signal representative of a time-domain input that specifies incrementally adjusting a level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes along a pre-defined sequence of steps.

2. The method of claim 1, wherein the time-domain input comprises actuation of control inputs including play, rewind, stop, and fast-forward inputs.

3. The method of claim 2, wherein the control inputs each define a progression through the pre-defined sequence of steps.

4. The method of claim 1, further comprising receiving the time-domain input from a user in an external programmer, wherein the signal is received from the external programmer.

5. The method of claim 1, further comprising automatically proceeding through the pre-defined sequence of steps until the signal representative of the time-domain input is received.

6. The method of claim 1, further comprising, in response to receiving the signal representative of the time-domain input, automatically proceeding through the pre-defined sequence of steps.

7. The method of claim 1, wherein delivering electrical stimulation to the patient via the second subset of the electrodes comprises delivering electrical stimulation to the patient via the second subset of the electrodes on a time-interleaved basis with the electrical stimulation delivered via the first subset of the electrodes.

8. The method of claim 1, further comprising incrementally adjusting the level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes according to the received signal.

9. The method of claim 8, wherein incrementally adjusting the level of electrical stimulation comprises one of incrementally increasing or incrementally decreasing the level of electrical stimulation.

10. The method of claim 1, further comprising presenting a graph with the pre-defined sequence of steps via a user interface.

11. The method of claim 1, further comprising skipping one or more steps in the pre-defined sequence of steps when incrementally decreasing the level of electrical stimulation.

12. The method of claim 1, wherein a signal representative of the time-domain input one of specifies the input in the time-domain or specifies the incremental adjustment pre-determined by an external programmer based on time-domain input from a user.

13. A medical device comprising:

means for delivering electrical stimulation to a patient via a first subset of a plurality of electrodes;

means for delivering electrical stimulation to the patient via a second subset of the electrodes; and

means for receiving a signal representative of a time-domain input that specifies incrementally adjusting a level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes along a pre-defined sequence of steps.

14. The medical device of claim 13, wherein the time-domain input comprises actuation of control inputs including play, rewind, stop, and fast-forward inputs.

15. The medical device of claim 14, wherein the control inputs each define a progression through the pre-defined sequence of steps.

16. The medical device of claim 13, further comprising means for automatically proceeding through the pre-defined sequence of steps until the signal is received.

17. The medical device of claim 13, further comprising means for automatically proceeding through the pre-defined sequence of steps in response to receiving the signal representative of the time-domain input.

18. The medical device of claim 13, wherein the means for delivering electrical stimulation to the patient via the second subset of the electrodes comprises means for delivering electrical stimulation to the patient via the second subset of the electrodes on a time-interleaved basis with the electrical stimulation delivered via the first subset of the electrodes.

19. The medical device of claim 13, further comprising means for incrementally adjusting the level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes according to the time-domain input.

20. The medical device of claim 19, wherein the means for incrementally adjusting the level of electrical stimulation comprises means for one of incrementally increasing or incrementally decreasing the level of electrical stimulation.

21. The medical device of claim 13, wherein the means for receiving the signal comprises means for receiving the signal from an external programmer configured to present a graph with the pre-defined sequence of steps.

22. A medical device comprising:

an electrical stimulation generator configured to deliver electrical stimulation to a patient via a first subset of a plurality of electrodes and deliver electrical stimulation to the patient via a second subset of the electrodes; and

a controller configured to receive a signal representative of a time-domain input that specifies incrementally adjusting a level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes along a pre-defined sequence of steps.

23. The medical device of claim 22, wherein the time-domain input comprises control inputs including play, rewind, stop, and fast-forward inputs.

24. The medical device of claim 23, wherein the control inputs each define a progression through the pre-defined sequence of steps.

25. The medical device of claim 22, wherein the controller is configured to automatically proceed through the pre-defined sequence of steps until the signal is received.

26. The medical device of claim 22, wherein the controller is configured to automatically proceed through the pre-defined sequence of steps in response to receiving the signal representative of the time-domain input.

27. The medical device of claim 22, wherein the electrical stimulation generator is configured to deliver electrical stimulation to the patient via the second subset of the electrodes on a time-interleaved basis with the electrical stimulation delivered via the first subset of the electrodes.

28. The medical device of claim 22, wherein the electrical stimulation generator is configured to incrementally adjust the level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes according to the time-domain input.

29. The medical device of claim 28, wherein the electrical stimulation generator is configured to one of incrementally increase or incrementally decrease the level of electrical stimulation.

30. The medical device of claim 22, wherein the controller is configured to receive the signal from an external programmer comprising a user interface configured to present a graph with the pre-defined sequence of steps.

31. The medical device of claim 22, wherein the signal received by the controller is representative of a non-directional time-domain input.

32. A method comprising:

delivering electrical stimulation to a patient via a first subset of a plurality of electrodes;

delivering electrical stimulation to the patient via a second subset of the electrodes; and

receiving a time-domain input in an external programmer from a user, wherein the time-domain input specifies incrementally adjusting a level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes along a pre-defined sequence of steps.

33. The method of claim 32, further comprising transmitting a signal representative of the time-domain input to an implantable medical device configured to deliver electrical stimulation, wherein the signal specifies the incremental adjustment.

34. A system comprising:

an implantable medical device configured to deliver electrical stimulation to a patient via a first subset of a plurality of electrodes and deliver electrical stimulation to the patient via a second subset of the electrodes; and

an external programmer configured to receive a time-domain input from a user, wherein the time-domain input specifies incrementally adjusting a level of at least one of the electrical stimulation delivered to the patient via the first subset of the electrodes and the electrical stimulation delivered to the patient via the second subset of the electrodes along a pre-defined sequence of steps.

35. The system of claim 34, wherein the external programmer is configured to transmit a signal representative of the time-domain input to the implantable medical device, and wherein the signal specifies the incremental adjustment.