Automated programming of electrical stimulation electrodes using post-implant imaging

• US 9,259,589 B2
• Filed: 09/03/2014
• Issued: 02/16/2016
• Est. Priority Date: 01/31/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Goetz, Steven M., Dewing, Wende L.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US14/476,309
• Publication Number:
  US 20140371819A1
• Time in Patent Office: 531 Days
• Field of Search: 607/2, 607/57
• US Class Current: 1/1
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• 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 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: G06T 2207/10116 X-ray image
• CPC Class Codes: G06T 2207/30052 Implant; Prosthesis
• CPC Class Codes: G06T 2207/30196 Human being; Person
• CPC Class Codes: G06T 7/0012 Biomedical image inspection
• CPC Class Codes: G06T 7/73 using feature-based methods

Abstract

In general, the disclosure is related to characterization of implanted electrical stimulation electrode arrays using post-implant imaging. The electrode arrays may be carried by implanted leads. Characterization of implanted electrode arrays may include identification of the type or types of leads implanted within a patient and/or determination of positions of the implanted leads or electrodes carried by the leads relative to one another or relative to anatomical structures within the patient. In addition, the disclosure relates to techniques for specifying or modifying patient therapy parameters based on the characterization of the implanted electrode arrays.

Claims

1. A system comprising:

an implantable medical device (IMD); and

a programmer comprising;

an interface configured to receive a first electronic image of a plurality of electrical stimulation leads implanted within a patient and coupled to the IMD, wherein each one of the electrical stimulation leads includes one or more electrodes; and

one or more processors configured to;

receive a second, different electronic image of the electrical stimulation leads implanted within the patient and coupled to the IMD;

compare locations of respective electrodes in the first electronic image to locations of respective electrodes in the second electronic image;

determine a change in position of one or more of the electrical stimulation leads based on the comparison of the locations of the respective electrodes in the first electronic image to the locations of the respective electrodes in the second electronic image;

automatically generate an adjustment to electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined change in position; and

cause the interface to transmit information of the adjustment to the electrical stimulation therapy to the IMD for the IMD to provide stimulation based on the adjusted electrical stimulation therapy.

2. The system of claim 1, wherein the adjustment to the electrical stimulation therapy includes one of:

an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads;

or

an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads.

3. The system of claim 1, further comprising:

a memory,

wherein the one or more processors are configured to receive the second electronic image from the memory.

4. The system of claim 1, wherein the interface is configured to receive the second electronic image, and wherein the one or more processors are configured to receive the second electronic image from the interface.

5. The system of claim 1, wherein to determine the change in the position of the one or more of the electrical stimulation leads, the one or more processors are configured to determine one or more inter-electrode distances, and wherein to automatically generate the adjustment to the electrical stimulation therapy, the one or more processors are configured to automatically generate the adjustment to the electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined inter-electrode distances.

6. The system of claim 1, wherein the one or more processors are configured to generate an indication of lead migration based on the determined change in position.

7. The system of claim 1, wherein the one or more processors are further configured to generate a programming search sequence for electrode combinations for delivery of electrical stimulation therapy based on the determined change in position, and wherein the one or more processors are configured to generate the adjustment to the electrical therapy based further on the generated programming search sequence.

8. The system of claim 1, wherein the one or more processors are further configured to automatically inhibit selection of particular electrode combinations for delivery of electrical stimulation therapy based on the determined change in position, and wherein the one or more processors are configured to automatically generate the adjustment to the electrical stimulation therapy based further on the inhibited selection of particular electrode combinations.

9. A device comprising:

an image analysis interface configured to obtain an analysis of a comparison of locations of respective electrodes in a first electronic image of a plurality of electrical stimulation leads implanted within a patient to locations of respective electrodes in a second, different electronic image of the plurality of electrical stimulation leads, wherein each one of the plurality of leads includes one or more electrodes; and

one or more processors configured to determine a change in position of one or more of the electrical stimulation leads based on the comparison of the locations of the respective electrodes in the first electronic image to the locations of the respective electrodes in the second electronic image, and automatically generate an adjustment to electrical stimulation therapy delivered via at least one of the leads based on the determined change in position.

10. The device of claim 9, wherein the adjustment to the electrical stimulation therapy includes one of:

an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads;

or

an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads.

11. The device of claim 9, wherein to determine the change in the position of the one or more of the electrical stimulation leads, the one or more processors are configured to determine one or more inter-electrode distances based on the comparison of the locations of the respective electrodes in the first electronic image to the locations of the respective electrodes in the second electronic image, and wherein to automatically generate the adjustment to the electrical stimulation therapy, the one or more processors are configured to automatically generate the adjustment to the electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined inter-electrode distances.

12. A device comprising:

an interface configured to receive a first electronic image of a plurality of electrical stimulation leads implanted within a patient and coupled to an implantable medical device (IMD), wherein each one of the electrical stimulation leads includes one or more electrodes; and

one or more processors configured to;

receive a second, different electronic image of the electrical stimulation leads implanted within the patient and coupled to the IMD;

compare locations of respective electrodes in the first electronic image to locations of respective electrodes in the second electronic image;

determine a change in position of one or more of the electrical stimulation leads based on the comparison of the locations of the respective electrodes in the first electronic image to the locations of the respective electrodes in the second electronic image;

automatically generate an adjustment to electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined change in position; and

cause the interface to transmit information of the adjustment to the electrical stimulation therapy to the IMD for the IMD to provide stimulation based on the adjusted electrical stimulation therapy.

13. The device of claim 12, wherein the adjustment to the electrical stimulation therapy includes one of:

an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads;

or

an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads.

14. The device of claim 12, further comprising:

a memory,

wherein the one or more processors are configured to receive the second electronic image from the memory.

15. The device of claim 12, wherein the interface is configured to receive the second electronic image, and wherein the one or more processors are configured to receive the second electronic image from the interface.

16. The device of claim 12, wherein to determine the change in the position of the one or more of the electrical stimulation leads, the one or more processors are configured to determine one or more inter-electrode distances, and wherein to automatically generate the adjustment to the electrical stimulation therapy, the one or more processors are configured to automatically generate the adjustment to the electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined inter-electrode distances.

17. The device of claim 12, wherein the one or more processors are configured to generate an indication of lead migration based on the determined change in position.

18. A method comprising:

obtaining an analysis of a comparison of locations of respective electrodes in a first electronic image of a plurality of electrical stimulation leads implanted within a patient to locations of respective electrodes in a second, different electronic image of the electrical stimulation leads, wherein each one of the electrical stimulation leads includes one or more electrodes;

determining a change in position of one or more of the electrical stimulation leads based on the comparison of the locations of the respective electrodes in the first electronic image to the locations of the respective electrodes in the second electronic image;

automatically generating an adjustment to electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined change in position; and

transmitting information of the adjustment to the electrical stimulation therapy to an implantable medical device (IMD) for the IMD to provide stimulation based on the adjusted electrical stimulation therapy.

19. The method of claim 18, wherein the adjustment to the electrical stimulation therapy includes one of:

an adjustment of one or more parameters associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads;

or

an adjustment of one or more electrode combinations associated with the electrical stimulation therapy delivered via at least one of the electrical stimulation leads.

20. The method of claim 18, wherein determining the change in the position of the one or more of the electrical stimulation leads comprising determining one or more inter-electrode distances, and wherein automatically generating the adjustment to the electrical stimulation therapy comprises automatically generating the adjustment to the electrical stimulation therapy delivered via at least one of the electrical stimulation leads based on the determined inter-electrode distances.

21. The method of claim 18, further comprising:

generating an indication of lead migration based on the determined change in position.

22. The method of claim 18, further comprising:

automatically generating a programming search sequence for electrode combinations for delivery of electrical stimulation therapy based on the determined change in position,

wherein automatically generating the adjustment to electrical stimulation therapy comprises automatically generating the adjustment to electrical stimulation therapy based further on the generated programming search sequence.

23. The method of claim 18, further comprising:

automatically inhibiting selection of particular electrode combinations for delivery of electrical stimulation therapy based on the determined change in position,

wherein automatically generating the adjustment to electrical stimulation therapy comprises automatically generating the adjustment to the electrical stimulation therapy based further on the inhibited selection of particular electrode combinations.