COMBINATION THERAPY INCLUDING PERIPHERAL NERVE FIELD STIMULATION

• US 20160279411A1
• Filed: 03/28/2016
• Published: 09/29/2016
• Est. Priority Date: 06/09/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rooney, Ethan A., Wahlstrand, Carl D., King, Gary W., Cross, Thomas E. Jr., Heruth, Kenneth T., Wacnik, Paul W., Evanson, Jeffrey S.
• Granted Patent: US 10,300,273 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 5/14 Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0553 Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings

Abstract

Delivery of peripheral nerve field stimulation (PNFS) in combination with one or more other therapies is described. The other therapy delivered in combination with PNFS may be, for example, a different type of neurostimulation, such as spinal cord stimulation (SCS), or a drug. PNFS and the other therapy may be delivered simultaneously, in an alternating fashion, according to a schedule, and/or selectively, e.g., in response to a request received from a patient or clinician. A combination therapy that includes PNFS may be able to more completely address complex or multifocal pain than would be possible through delivery of either PNFS or other therapies alone. Further, the combination of PNFS with one or more other therapies may reduce the likelihood that neural accommodation will impair the perceived effectiveness PNFS or the other therapies.

Claims

1. (canceled)

2. :

An implantable medical device system comprising;

an implantable medical device configured to deliver a first therapy to a patient via a first implantable element and a deliver a second therapy to the patient via a second implantable element in combination with delivery of the first therapy; and

a processor configured to control the implantable medical device to deliver, via the first implantable element, the first therapy to the patient according to a duty cycle such that the first therapy delivery is cycled on and off, and control the implantable medical device to deliver the second therapy, via the second implantable element, such that the second therapy is not cycled on and off according to a duty cycle.

3. :

The system of claim 2, wherein the processor is configured to control the delivery of the second therapy to the patient based upon receipt of a request from a user.

4. :

The system of claim 2, wherein the first implantable element is configured to deliver the first therapy to a first anatomical region and the second implantable element is configured to deliver the second therapy to a second anatomical region.

5. :

The system of claim 4, wherein the first anatomical region comprises one of a spinal cord or a limb of the patient, and wherein the second anatomical region comprises another of the spinal cord or the limb of the patient.

6. :

The system of claim 2, wherein one of the first therapy and the second therapy comprises peripheral nerve field stimulation therapy, and another of the first therapy and the second therapy comprises a therapy configured to treat pain to the patient in combination with the peripheral nerve field stimulation.

7. :

The system of claim 2, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy and wherein the processor is configured to control the implantable medical device to deliver the first electrical stimulation therapy to be time-interleaved with the second electrical stimulation therapy.

8. :

The system of claim 2, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy, and wherein an amplitude of electrical stimulation pulses of the first electrical stimulation therapy is different from an amplitude of electrical stimulation pulses of the second electrical stimulation.

9. :

The system of claim 2, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy, and wherein a frequency of electrical stimulation pulses of the first electrical stimulation therapy is different from a frequency of electrical stimulation pulses of the second electrical stimulation therapy.

10. :

The system of claim 2, further comprising a medical device programmer configured to communicate wirelessly with the implantable medical device, wherein the programmer is configured to program the implantable medical device via the wireless communication.

11. :

The system of claim 2, wherein the first therapy comprises electrical stimulation therapy, and the second therapy comprises drug delivery therapy.

12. :

The system of claim 2, further comprising the first implantable element and the second implantable element.

13. :

The system of claim 2, wherein the implantable medical device includes a first implantable medical device configured to deliver the first therapy to the patient via the first implantable element, and a second implantable medical device configured to deliver the second therapy to the patient via the second implantable element.

14. :

A method comprising;

controlling, via a processor, delivery of a first therapy to a patient via a first implantable element according to a duty cycle such that the first therapy delivery is cycled on and off; and

controlling, via the processor, delivery of a second therapy to the patient via a second implantable element in combination with delivery of the first therapy, wherein the second therapy is not delivered according to a duty cycle.

15. :

The method of claim 14, further comprising receiving user input requesting delivery of the second therapy, wherein controlling delivery of the second therapy to the patient comprises controlling the delivery of the second therapy to the patient based upon receipt of the request from a user.

16. :

The method of claim 14, wherein the first implantable element is configured to deliver the first therapy to a first anatomical region and the second implantable element is configured to deliver the second therapy to a second anatomical region.

17. :

The method of claim 16, wherein the first anatomical region comprises one of a spinal cord or a limb of the patient, and wherein the second anatomical region comprises another of the spinal cord or the limb of the patient.

18. :

The method of claim 14, wherein one of the first therapy and the second therapy comprises peripheral nerve field stimulation therapy, and the other of the first therapy and the second therapy comprises a therapy configured to treat pain to the patient in combination with the peripheral nerve field stimulation.

19. :

The method of claim 14, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy, and wherein controlling the delivery of the second therapy to the patient in combination with the delivery of the first therapy comprises controlling delivery of the first electrical stimulation therapy to be time-interleaved with the second electrical stimulation therapy.

20. :

The method of claim 14, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy, and wherein an amplitude of electrical stimulation pulses of the first electrical stimulation therapy is different from an amplitude of electrical stimulation pulses of the second electrical stimulation.

21. :

The method of claim 14, wherein the first therapy comprises a first electrical stimulation therapy and the second therapy comprises a second electrical stimulation therapy, and wherein a frequency of electrical stimulation pulses of the first electrical stimulation therapy is different from a frequency of electrical stimulation pulses of the second electrical stimulation therapy.

22. :

The method of claim 14, wherein the first therapy comprises electrical stimulation therapy, and the second therapy comprises drug delivery therapy.