Delivering scheduled and unscheduled therapy without detriment to battery life or accuracy of longevity predictions

• US 8,874,229 B2
• Filed: 04/28/2010
• Issued: 10/28/2014
• Est. Priority Date: 04/28/2010
• Status: Active Grant

• Current Assignee: CYBERONCS, INC.
• Sponsoring Entity: CYBERONCS, INC.
• Inventors: Colborn, John C.
• Primary Examiner(s): Kahelin, Michael
• Assistant Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• APPLICATION: US 20110270359A1
• Time in USPTO: 1644 Days
• Field of Search: 607/6, 607/15, 607/52, 607/45, 607/46, 607/66, 607 70- 76, 607/9
• US Class Current: 607/62
• CPC Class Codes: A61N 1/025 : Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/08 : Arrangements or circuits for monitoring, protecting, controlling or indicating for external stimulators A61N1/3603; for implantable neurostimulators A61N1/36128; for heart stimulators A61N1/37; for defibrillators A61N1/3925
• CPC Class Codes: A61N 1/36114 : Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/378 : Electrical supply

Abstract

A method comprises applying a first open-loop electrical signal to a neural structure at a first rate. The method also comprises applying a closed-loop electrical signal to the neural structure in response to an event detection, thus causing an overall rate at which electrical stimulation is applied to the neural structure to exceed the first rate. The method further comprises applying a second open-loop electrical signal to a neural structure at a second rate that is lower than the first rate, thus causing the overall rate to be reduced to the first rate.

Claims

1. A method comprising:

applying an electrical signal of electrical signals of scheduled stimulation to a neural structure via an implantable medical device (IMD), wherein the scheduled stimulation is defined by a plurality of parameters and characterized by a first rate of electrical charge delivery to the neural structure, and wherein the first rate is based on one or more of the plurality of parameters;

detecting an event at the IMD after application of the electrical signal and before application of a next scheduled electrical signal of the scheduled stimulation;

applying event stimulation to the neural structure via the IMD in response to detection of the event;

adjusting at least one parameter of the plurality of parameters that define the scheduled stimulation in response to detection of the event to define adjusted stimulation characterized by a second rate of electrical charge delivery to the neural structure that is less than the first rate;

applying the adjusted stimulation to the neural structure via the IMD after application of the event stimulation to compensate for electrical charge delivery due to the event stimulation; and

applying at least one electrical signal of the scheduled stimulation to the neural structure via the IMD after application of the adjusted stimulation.

2. The method of claim 1, wherein the scheduled stimulation comprises a plurality of pulse bursts separated by an off-time period, and wherein applying the adjusted stimulation to the neural structure comprises skipping at least one pulse burst of the scheduled stimulation after the application of the event stimulation.

3. The method of claim 1, further comprising determining an intervention time associated with the application of the event stimulation, wherein the scheduled stimulation comprises a plurality of pulse bursts separated by a first off-time period, wherein the adjusted stimulation comprises at least one pulse burst followed by a second off-time period, wherein the intervention time is a difference between the first off-time period and an actual off-time elapsed from application of the electrical signal to the application of the event stimulation, and wherein the second off-time period is determined by adding at least a portion of the intervention time to the first off-time period.

4. The method of claim 1, wherein the scheduled stimulation comprises a plurality of electrical pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, wherein applying the adjusted stimulation to the neural structure comprises delivering n pulse bursts after application of the event stimulation, and wherein the n pulse bursts are defined by a second on-time that is shorter than the first on-time.

5. The method of claim 1, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, wherein the adjusted stimulation comprises at least one pulse burst having a second on-time followed by a second off-time, wherein applying the event stimulation comprises generating an event electrical signal having a duration defined by a fraction of the first off-time;

and wherein the second on-time is defined by a second fraction of the first off-time.

6. A system, comprising:

detection logic adapted to detect an event; and

stimulation logic coupled to the detection logic and adapted to apply scheduled stimulation, adjusted stimulation, and event stimulation to a neural structure;

wherein the scheduled stimulation is characterized by a plurality of parameters and by a first rate of electrical charge delivery to the neural structure that is based on the plurality of parameters;

wherein, upon receipt of notification from the detection logic of detection of the event after application of an electrical signal of the scheduled stimulation and before application of a next scheduled electrical signal of the scheduled stimulation, the stimulation logic applies event stimulation to the neural structure;

wherein, upon application of the event stimulation to the neural structure, the stimulation logic adjusts one or more parameters of the plurality of parameters to define the adjusted stimulation, wherein the adjusted stimulation is characterized by a second rate of electrical charge delivery to the neural structure that is less than the first rate; and

wherein application of the adjusted stimulation to the neural structure compensates for electrical charge delivery due to the event stimulation.

7. The system of claim 6, wherein the stimulation logic is adapted to apply one or more electrical signals of the scheduled stimulation to the neural structure after application of the adjusted stimulation to the neural structure.

8. The system of claim 7, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first programmed off-time, and wherein the adjusted stimulation comprises the first off-time, and wherein the scheduled stimulation, starting with a pulse burst, resumes after the first off-time of the adjusted stimulation.

9. The system of claim 6, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, and wherein the stimulation logic skips a next pulse burst of the scheduled stimulation after the application of the event stimulation.

10. The system of claim 6, wherein the scheduled stimulation comprises a plurality of pulse bursts separated by a first off-time period, wherein the adjusted stimulation comprises at least one pulse burst followed by a second off-time period, wherein the stimulation logic determines an intervention time associated with the application of the event stimulation, wherein the intervention time is a difference between the first off-time period and an actual off-time elapsed from application of the electrical signal to the application of the event stimulation, and wherein a least a portion of the intervention time is added to the firstoff-time period to determine the second off-time period.

11. The system of claim 6, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, wherein the stimulation logic delivers n pulse bursts after application of the event stimulation, and wherein the n pulse bursts are defined by a second on-time that is shorter than the first on-time.

12. The system of claim 6, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, wherein the adjusted stimulation comprises at least one pulse burst having a second on-time followed by a second off-time, wherein the stimulation logic generates the event stimulation having a duration defined by a fraction of the first off-time, and wherein the second on-time is defined by a second fraction of the first off-time.

13. A non-transitory computer-readable medium comprising instructions executable by a processor to:

cause an electrical signal of electrical signals of scheduled stimulation to be sent to an electrode assembly, wherein the scheduled stimulation is characterized by a first charge delivery rate;

cause event stimulation to be sent to the electrode assembly in response to detection of an event after the electrical signal is sent and before a next scheduled electrical signal of the scheduled stimulation is to be sent;

determine adjusted stimulation characterized by a second electrical charge delivery rate that is less than the first charge delivery rate to compensate for electrical charge delivery due to the event stimulation sent to the electrode assembly; and

cause the adjusted stimulation to be sent to the electrode assembly.

14. The non-transitory computer-readable medium of claim 13, further comprising instructions executable by the processor to resume delivery of the scheduled stimulation to the electrode assembly after the adjusted stimulation is sent to the electrode assembly.

15. The non-transitory computer-readable medium of claim 13, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, wherein the event stimulation comprises a pulse burst with a duration of the first on-time that begins a first time after an end of the electrical signal, and wherein the adjusted stimulation has a second off-time followed by a pulse burst with a duration of the first on-time, wherein the second off-time equals the first off-time plus a difference between the first off-time and the first on-time.

16. The non-transitory computer-readable medium of claim 13, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein each pulse burst is separated from an adjacent pulse burst by a first off-time, and wherein the instructions executable by the processor to determine the adjusted stimulation comprise instructions executable by the processor to:

determine a time difference between an end of a pulse burst of the electrical signal and a start of a pulse burst of the event stimulation;

schedule a first pulse burst of the adjusted stimulation to begin after the first off-time elapses from an end of the pulse burst of the event stimulation; and

schedule one or more additional pulse bursts of the adjusted stimulation, wherein the one or more additional pulse bursts are to begin after an elapse time from a most recent pulse burst, wherein the elapse time equals the first off-time plus the time difference divided by a number of the one or more additional pulse bursts.

17. The non-transitory computer-readable medium of claim 13, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein the event stimulation comprises a pulse burst with a duration of the first on-time, wherein the adjusted stimulation comprises one or more second pulse bursts, and wherein a duration of at least one second pulse burst is less than the first on-time.

18. The non-transitory computer-readable medium of claim 13, wherein the scheduled stimulation comprises a plurality of pulse bursts, wherein each pulse burst has a duration defined by a first on-time, wherein the event stimulation comprises a pulse burst with a duration that is less than the first on-time, and wherein the adjusted stimulation comprises one or more second pulse bursts, and wherein a duration of at least one second pulse burst is less than the first on-time.

19. The non-transitory computer-readable medium of claim 13, wherein detection of the event comprises receipt of manual activation of signal delivery.

20. The non-transitory computer-readable medium of claim 13, wherein the instructions executable by the processor further comprise instructions executable by the processor to make a determination that at least one detected body parameter is outside of an acceptable range for the least one body parameter to detect the event.