System and method for using cardiac events to trigger therapy for treating nervous system disorders
First Claim
1. A method of treating a nervous system disorder in a patient, the method comprising:
- sensing a brain signal from the patient;
obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal;
sensing a cardiac signal from the patient;
obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal;
analyzing timing relationships between detected events before enabling therapy delivery for treating a neurological disorder in response to a cardiac event, the detected events including detected neurological events and detected cardiac events;
identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events;
determining that the cardiac event detection signal facilitates detection of neurological events when the timing relationships between detected neurological events and detected cardiac events meet one or more predetermined criteria; and
delivering a therapy to the patient for treating the neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
1 Assignment
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Accused Products
Abstract
A method of treating a neurological disorder in a patient. In some embodiments, the method includes obtaining a neurological event detection signal, obtaining a cardiac event detection signal, analyzing the timing relationships between the detected neurological and cardiac events to identify matched events, using the matched events to determine whether the cardiac event detection signal facilitates detection of neurological events, delivering a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events, and changing the therapy delivered based on sensed brain signals from the patient.
168 Citations
79 Claims
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1. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events before enabling therapy delivery for treating a neurological disorder in response to a cardiac event, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining that the cardiac event detection signal facilitates detection of neurological events when the timing relationships between detected neurological events and detected cardiac events meet one or more predetermined criteria; and delivering a therapy to the patient for treating the neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; calculating a rate of concordance between the neurological event detection signal and cardiac event detection signal, and determining that the cardiac event detection signal facilitates detection of the neurological events when the rate of concordance exceeds a threshold, wherein calculating the rate of concordance comprises dividing a number of matched events by a number of detected neurological events; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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40. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; identifying a false positive event when one of the detected cardiac events is not temporally related to one of the detected neurological events, and determining whether the cardiac event detection signal facilitates detection of neurological events based upon matched events and false positive events; calculating a false positive rate, the false positive rate being equal to a number of false positive events divided by a number of detected neurological events, and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (41)
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42. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; identifying a false positive event when one of the detected cardiac events is not temporally related to one of the detected neurological events, and determining whether the cardiac event detection signal facilitates detection of neurological events based upon matched events and false positive events; calculating a false positive rate, the false positive rate being equal to a number of false positive events per unit of time, and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (43)
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44. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; for each of the matched events, determining a latency of the detected cardiac event with respect to a detected neurological event, wherein determining latency comprises calculating a representative value of a time by which the matched cardiac events precede the corresponding matched neurological events; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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45. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; for each of the matched events, determining a latency of the detected cardiac event with respect to a detected neurological event, wherein determining latency comprises calculating how frequently the matched cardiac events precede the corresponding matched neurological events; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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46. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; for each of the matched events, determining a latency of the detected cardiac event with respect to a detected neurological event; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events, wherein delivering the therapy to the patient further requires the latency of the detected cardiac events to meet a predetermined criterion.
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47. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; calculating a false negative rate, the false negative rate being equal to a number of false negative events divided by a number of detected neurological events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (48)
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49. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; calculating a rate of concordance between the neurological and cardiac event detection signals, the rate of concordance being equal to a number of matched events divided by a number of detected neurological events; calculating a false positive rate, the false positive rate being equal to a number of false positive events divided by the number of detected neurological events; calculating a false negative rate, the false negative rate being equal to a number of false negative events divided by the number of detected neurological events; for each of the matched events, determining a latency of the detected cardiac event with respect to a detected neurological event; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events, wherein delivering the therapy to the patient further requires a combination of the rate of concordance, false positive rate, false negative rate, and latency of the detected cardiac events to meet predetermined criteria.
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50. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; calculating a rate of concordance between the neurological and cardiac event detection signals, the rate of concordance being equal to a number of matched events divided by a number of detected neurological events; calculating a false positive rate, the false positive rate being equal to a number of false positive events per unit of time; calculating a false negative rate, the false negative rate being equal to a number of false negative events per unit of time; for each of the matched events, determining a latency of the detected cardiac event with respect to a detected neurological event; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events, wherein delivering the therapy to the patient further requires a combination of the rate of concordance, false positive rate, false negative rate, and latency of the detected cardiac events to meet predetermined criteria.
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51. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events; and for the cardiac events classified as matched, further classifying the cardiac events as either; (a) overlapping, if (i) the cardiac event has a beginning time that occurs before an end time of the matched neurological event, (ii) the cardiac event has a termination time that occurs after a start time of the matched neurological event;
or(b) non-overlapping. - View Dependent Claims (52, 53, 54, 55, 56, 57, 58, 59, 60, 61)
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62. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between detected events, the detected events including detected neurological events and detected cardiac events; identifying a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determining whether the cardiac event detection signal facilitates detection of neurological events based on matched events; classifying each matched event into one of two or more categories based upon the timing relationship between the cardiac and neurological events; assigning a weighting factor to each matched event based upon the category for each matched event; calculating a rate of concordance between the neurological and cardiac event detection signals utilizing the weighting factors, wherein calculating the rate of concordance comprises dividing a weighted sum of matched events by a number of detected neurological events; determining that the cardiac event detection signal facilitates detection of the neurological events when the rate of concordance exceeds a threshold; and delivering a therapy to the patient for treating a neurological disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (63, 64)
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65. An implantable medical device (IMD) for treating a neurological disorder in a patient, the device comprising:
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a biocompatible housing adapted to be implanted in a patient; a power source; a therapy module; and a processor, the processor being configured to receive a brain signal from the patient, derive a neurological event detection signal from the brain signal, the neurological event detection signal indicating detected neurological events in the patient, receive a cardiac signal from the patient, derive a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient, analyze timing relationships between detected neurological events and cardiac events before enabling therapy delivery for treating a neurological disorder in response to a cardiac event, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine that the cardiac event detection signal facilitates detection of neurological events when the timing relationships between detected neurological events and detected cardiac events meet one or more predetermined criteria, and cause the therapy module to deliver a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events. - View Dependent Claims (66, 67, 68, 69, 70, 71, 72)
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73. An implantable medical device (IMD) for treating a neurological disorder in a patient, the device comprising:
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a biocompatible housing adapted to be implanted in a patient; a power source; a therapy module; and a processor, the processor being configured to receive a brain signal from the patient, derive a neurological event detection signal from the brain signal, the neurological event detection signal indicating detected neurological events in the patient, receive a cardiac signal from the patient, derive a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient, analyze timing relationships between detected neurological events and cardiac events, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine whether the cardiac event detection signal facilitates detection of neurological events based on the matched events, calculate a rate of concordance between the neurological and cardiac event detection signals and determine that the cardiac event detection signal facilitates detection of the neurological events when the rate of concordance exceeds a threshold, wherein calculating the rate of concordance comprises dividing a number of matched events by a number of detected neurological events, and cause the therapy module to deliver a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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74. An implantable medical device (IMD) for treating a neurological disorder in a patient, the device comprising:
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a biocompatible housing adapted to be implanted in a patient; a power source; a therapy module; and a processor, the processor being adapted configured to receive a brain signal from the patient, derive a neurological event detection signal from the brain signal, the neurological event detection signal indicating detected neurological events in the patient, receive a cardiac signal from the patient, derive a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient, analyze timing relationships between detected neurological events and cardiac events, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine whether the cardiac event detection signal facilitates detection of neurological events based on the matched events, identify a false positive event when one of the detected cardiac events is not temporally related to one of the detected neurological events, calculate a false positive rate, the false positive rate being equal to a number of false positive events divided by a number of detected neurological events, enable use of the cardiac event detection signal to detect neurological events when the false positive rate is below a predetermined level, and cause the therapy module to deliver a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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75. An implantable medical device (IMD) for treating a neurological disorder in a patient, the device comprising:
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a biocompatible housing adapted to be implanted in a patient; a power source; a therapy module; and a processor, the processor being configured to receive a brain signal from the patient, derive a neurological event detection signal from the brain signal, the neurological event detection signal indicating detected neurological events in the patient, receive a cardiac signal from the patient, derive a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient, analyze timing relationships between detected neurological events and cardiac events, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine whether the cardiac event detection signal facilitates detection of neurological events based on the matched events, identify a false positive event when one of the detected cardiac events is not temporally related to one of the detected neurological events, calculate a false positive rate, the false positive rate being equal to a number of false positive events per unit of time, enable use of the cardiac event detection signal to detect neurological events when the false positive rate is below a predetermined level, and cause the therapy module to deliver a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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76. An implantable medical device (IMD) for treating a neurological disorder in a patient, the device comprising:
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a biocompatible housing adapted to be implanted in a patient; a power source; a therapy module; and a processor, the processor being configured to receive a brain signal from the patient, derive a neurological event detection signal from the brain signal, the neurological event detection signal indicating detected neurological events in the patient, receive a cardiac signal from the patient, derive a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient, analyze timing relationships between detected neurological events and cardiac events, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine whether the cardiac event detection signal facilitates detection of neurological events based on the matched events, calculate a false negative rate, the false negative rate being equal to a number of false negative events divided by a number of detected neurological events, enable use of the cardiac event detection signal to detect neurological events when the false negative rate is below a predetermined level, and cause the therapy module to deliver a therapy to the patient in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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77. A non-transitory computer-readable medium programmed with instructions for performing a method of treating a neurological disorder in a patient, the medium comprising instructions for causing a programmable processor to:
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obtain a neurological event detection signal, the neurological event detection signal indicating neurological events detected in a brain signal from the patient; obtain a cardiac event detection signal, the cardiac event detection signal indicating detected cardiac events in the patient; analyze timing relationships between detected neurological events and cardiac events before enabling therapy delivery for treating a neurological disorder in response to a cardiac event; identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events; determine that the cardiac event detection signal facilitates detection of neurological events when the timing relationships between detected neurological events and detected cardiac events meet one or more predetermined criteria; and cause a neurological therapy to be delivered to the patient in response to a detected cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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78. A system for treating a neurological disorder in a patient, the system comprising:
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communication means for obtaining a neurological event detection signal and a cardiac event detection signal, the neurological event detection signal indicating detected neurological events in the patient, the cardiac event detection signal indicating detected cardiac events in the patient; and a processor for analyzing timing relationships between detected neurological events and cardiac events, said processor being configured to analyze timing relationships between detected neurological events and detected cardiac events before enabling therapy delivery for treating a neurological disorder in response to a cardiac event, identify a matched event when one of the detected neurological events is temporally related to one of the detected cardiac events, determine that the cardiac event detection signal facilitates detection of neurological events when the timing relationships between detected neurological events and detected cardiac events meet one or more predetermined criteria, and cause delivery of a therapy to the patient for treating the neurological disorder in response to a detected cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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79. A method of treating a nervous system disorder in a patient, the method comprising:
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sensing a brain signal from the patient; obtaining a neurological event detection signal, the neurological event detection signal indicating neurological events detected from the brain signal; sensing a cardiac signal from the patient; obtaining a cardiac event detection signal, the cardiac event detection signal indicating cardiac events detected from the cardiac signal; analyzing timing relationships between a minimum number of detected neurological events and detected cardiac events before enabling therapy delivery for treating a nervous system disorder in response to a cardiac event; determining whether the cardiac event detection signal facilitates detection of neurological events based on the timing relationships between detected neurological events and detected cardiac events; and delivering a therapy to the patient for treating the nervous system disorder in response to a cardiac event if the cardiac event detection signal is determined to facilitate detection of neurological events.
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Specification