Customizable titration for an implantable neurostimulator

Patent metadata

Field	Value
Publication number	US-2024399153-A1
Application number	US-202418731997-A
Country	US
Kind code	A1
Filing date	Jun 3, 2024
Priority date	Sep 14, 2017
Publication date	Dec 5, 2024
Grant date	—

Abstract

Systems and methods for customizable titration of an implantable neurostimulator are provided. A method of titrating a neurostimulation signal delivered to a patient from an implantable pulse generator includes delivering a first neurostimulation signal with a first set of parameters, increasing a first value of the first neurostimulation signal at a first rate for a first period of time while delivering the first neurostimulation signal, ceasing delivery of the first neurostimulation signal when the first value reaches a first target value, delivering a second neurostimulation signal with a second set of parameters, and increasing the second neurostimulation signal at a second rate for a second period of time while delivering the second neurostimulation signal.

First claim

1 - 20 . (canceled)

21 . A method of titrating a neurostimulation signal delivered to a patient from an implantable pulse generator, the method comprising:
titrating an intensity of a neurostimulation signal delivered to a patient from an initial intensity to a first target intensity at a first titration rate; and upon reaching the first target intensity, titrating the intensity of the neurostimulation signal from the first target intensity to a second target intensity at a second titration rate different from the first titration rate, wherein the second titration rate is based on a titration period between the first target intensity and the second target intensity corresponding to a level of patient adaptation to titration of the neurostimulation signal.

22 . The method of claim 21 , wherein the titration period is a second titration period, the level of patient adaptation is a second level of patient adaptation, and a first titration period between the initial intensity and the first target intensity corresponds to a first level of patient adaptation that is different than the second level of patient adaptation.

23 . The method of claim 22 , wherein the second level of patient adaptation to titration is lower than the first level of patient adaptation such that the patient adapts more slowly to titration during the second titration period than the first titration period.

24 . The method of claim 23 , wherein the second titration rate is lower than the first titration rate.

25 . The method of claim 21 , wherein the intensity comprises one or more of an output current, a frequency, a pulse width, or a duty cycle of the neurostimulation signal.

26 . The method of claim 21 , further comprising:
upon reaching the second target intensity, titrating the intensity of the neurostimulation signal from the second target intensity to a third target intensity at a third titration rate different from the second titration rate, wherein the third titration rate is based on a second titration period between the second target intensity and the third target intensity corresponding to a second level of patient adaptation to titration of the neurostimulation signal.

27 . The method of claim 26 , wherein the third titration rate is equal to the first titration rate.

28 . A neurostimulation system comprising:
an implantable pulse generator configured to generate a neurostimulation signal; an electrode configured to deliver the neurostimulation signal to a patient; a lead coupling the electrode to the implantable pulse generator; and one or more processing circuits including one or more processors and one or more memories having instructions stored thereon that, when executed by the one or more processors, cause the one or more processing circuits to:
titrate an intensity of a neurostimulation signal delivered to a patient from an initial intensity to a first intensity at a first titration rate; and
titrate the intensity of the neurostimulation signal from the first intensity to a second intensity at a second titration rate different from the first titration rate,
wherein the second titration rate is based on a titration period between the first intensity and the second intensity corresponding to a level of patient adaptation to titration of the neurostimulation signal.

29 . The neurostimulation system of claim 28 , wherein the second titration rate is lower than the first titration rate.

30 . The neurostimulation system of claim 28 , wherein the titration period is a second titration period, the level of patient adaptation is a second level of patient adaptation, and a first titration period between the initial intensity and the first intensity corresponds to a first level of patient adaptation that is different than the second level of patient adaptation.

31 . The neurostimulation system of claim 30 , wherein the second level of patient adaptation to titration is lower than the first level of patient adaptation such that the patient adapts more slowly to titration during the second titration period than the first titration period.

32 . The neurostimulation system of claim 28 , wherein the intensity comprises one or more of an output current, a frequency, a pulse width, or a duty cycle of the neurostimulation signal.

33 . The neurostimulation system of claim 28 , wherein the instructions, when executed by the one or more processors, further cause the one or more processing circuits to:
titrate the intensity of the neurostimulation signal from the second intensity to a third intensity at a third titration rate different from the second titration rate, wherein the third titration rate is based on a second titration period between the second intensity and the third intensity corresponding to a second level of patient adaptation to titration of the neurostimulation signal.

34 . The neurostimulation system of claim 33 , wherein the third titration rate is equal to the first titration rate.

35 . A method comprising:
titrating an intensity of a neurostimulation signal delivered to a patient from an initial intensity to a first intensity at a first titration rate; and titrating the intensity of the neurostimulation signal from the first intensity to a second intensity at a second titration rate different from the first titration rate, wherein the second titration rate is based on a titration period between the first intensity and the second intensity corresponding to a rate of patient adaptation to titration of the neurostimulation signal.

36 . The method of claim 35 , wherein the titration period is a second titration period, the rate of patient adaptation is a second rate of patient adaptation, and a first titration period between the initial intensity and the first intensity corresponds to a first rate of patient adaptation that is different than the second rate of patient adaptation.

37 . The method of claim 36 , wherein the second rate of patient adaptation to titration is lower than the first rate of patient adaptation.

38 . The method of claim 35 , wherein the second titration rate is lower than the first titration rate.

39 . The method of claim 35 , wherein the intensity comprises one or more of an output current, a frequency, a pulse width, or a duty cycle of the neurostimulation signal.

40 . The method of claim 35 , further comprising:
upon reaching the second intensity, titrating the intensity of the neurostimulation signal from the second intensity to a third intensity at a third titration rate different from the second titration rate, wherein the third titration rate is based on a second titration period between the second intensity and the third intensity corresponding to a second rate of patient adaptation to titration of the neurostimulation signal.

Assignees

• Livanova Usa Inc

Inventors

• Stubbs Scott
• Libbus Imad
• Mazar Scott
• Kenknight Bruce
• Amurthur Badri

Classifications

• A61N1/37247

  User interfaces, e.g. input or presentation means · CPC title

• G16H20/30

  relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising · CPC title

• A61N1/37235

  Aspects of the external programmer · CPC title

• A61N1/36157

  Current (A61N1/3616 takes precedence) · CPC title

• A61N1/36171

  Frequency · CPC title