# US 10,369,367 B2 · System for providing stimulation pattern to modulate neural activity

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- Number: US 10,369,367 B2
- Document ID: US10369367B2
- Status: Granted
- Kind: B2
- Application number: 15/937,901
- Filed: 2018-03-28
- Published: 2018-10-11
- Granted: 2019-08-06
- Earliest claimed: 2003-12-24
- Assignees: Cardiac Pacemakers, Inc.
- Applicants: Cardiac Pacemakers, Inc.
- Inventors: Imad Libbus; Andrew P. Kramer
- Web page: https://patentgrep.com/patent/US10369367B2

## CPC

- A61N 1/36117: {for treating hypertension}
- A61N 1/3601: {of respiratory organs}
- A61N 1/3611: {Respiration control (stimulating respiratory organs A61N1/3601)}
- A61N 1/36114: {Cardiac control, e.g. by vagal stimulation (stimulating the heart A61N1/362)}
- A61N 1/36139: {with automatic adjustment}
- A61N 1/3614: {based on impedance measurement}
- A61N 1/36535: {controlled by body position or posture}
- A61N 1/36542: {controlled by body motion, e.g. acceleration}
- A61N 1/3655: {controlled by body or blood temperature}
- A61N 1/36564: {controlled by blood pressure}
- A61N 1/36571: {controlled by blood flow rate, e.g. blood velocity or cardiac output}
- A61N 1/37288: {Communication to several implantable medical devices within one patient}
- A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. Other embodiments are provided herein.

## Claims

### Claim 1

A system for use with at least one electrode, comprising:
an implantable device configured to use the at least one electrode to modulate neural activity, the implantable device comprising controller circuitry, memory, a transceiver, and a generator configured to generate electrical stimulation to modulate the neural activity;
the controller circuitry and the transceiver configured to cooperate to receive, from another device, information corresponding to a stimulation pattern and store data corresponding to the stimulation pattern in the memory, wherein the stimulation pattern includes a pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a wave morphology, the pattern of bursts with multiple burst durations and multiple burst interval sequences being different from a simple burst pattern of repeated bursts with one burst duration and burst interval; and
the controller circuitry operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation to provide the stimulation pattern that includes the pulses with the wave morphology and that includes the multiple burst durations and the multiple burst interval sequences.

### Claim 2 (depends on 1)

The system of claim 1, wherein the memory is configured to store a schedule, and instructions for controlling the generator to generate the stimulation pattern according to the schedule, and the controller circuitry is operably connected to the memory and the generator to use the instructions stored in the memory to control generation of the stimulation pattern according to the schedule.

### Claim 3 (depends on 1)

The system of claim 1, wherein the wave morphology includes a morphology that includes harmonic components to mimic naturally-occurring neural activity, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation to provide the morphology that includes the harmonic components to mimic naturally-occurring neural activity.

### Claim 4 (depends on 1)

The system of claim 1, wherein the wave morphology includes a square wave, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation to provide the stimulation pattern that includes the square wave.

### Claim 5 (depends on 1)

The system of claim 1, wherein the wave morphology includes a triangle wave, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation to provide the stimulation pattern that includes the triangle wave.

### Claim 6 (depends on 1)

The system of claim 1, wherein the wave morphology includes a sinusoidal wave, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation to provide the stimulation pattern that includes the sinusoidal wave.

### Claim 7 (depends on 1)

The system of claim 1, wherein the data corresponding to the stimulation pattern includes data corresponding to a duty cycle for a stimulation ON time during which electrical stimulation is generated and a stimulation OFF time during which electrical stimulation is not generated, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation according to the duty cycle.

### Claim 8 (depends on 1)

The system of claim 1, wherein the data corresponding to the stimulation pattern includes a circadian rhythm template, and the controller circuitry is operably connected to the memory and the generator and configured to use the data stored in the memory to control generation of the electrical stimulation according to the circadian rhythm template.

### Claim 9 (depends on 1)

The system of claim 1, further comprising a sensor to sense a parameter, wherein the controller circuitry and the generator are configured to cooperate to use the sensed parameter to modulate the pattern.

### Claim 10 (depends on 9)

The system of claim 9, wherein the controller circuitry and the generator are configured to cooperate to modulate at least one stimulation parameter in response to the sensed parameter, wherein the at least one stimulation parameter is selected from the group of parameters for the electrical energy consisting of:
an amplitude, a frequency, and a burst frequency.

### Claim 11 (depends on 1)

The system of claim 1, further comprising a patient posture sensor, wherein the controller circuitry and the generator are configured cooperate to use patient posture sensed by the patient posture sensor to modulate the pattern.

### Claim 12 (depends on 1)

The system of claim 1, further comprising an activity sensor, wherein the controller circuitry and the generator are configured to cooperate to use patient activity sensed by the activity sensor to modulate the pattern.

### Claim 13 (depends on 1)

The system of claim 1, wherein the controller circuitry is configured to determine a time of day, and the controller circuitry and the generator are configured to cooperate to use the time of day to modulate the pattern.

### Claim 14 (depends on 1)

The system of claim 1, further comprising a user interface, wherein the stimulation pattern is determined based on received user input at the user interface.

### Claim 15

A method performed by an implantable device configured to generate electrical stimulation to provide a stimulation pattern for use to modulate neural activity using at least one electrode, the method comprising:
receiving, from another device, information corresponding to the stimulation pattern, wherein the stimulation pattern includes a pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a wave morphology, the pattern of bursts with multiple burst durations and multiple burst interval sequences being different from a simple burst pattern of repeated bursts with one burst duration and burst interval;
storing data corresponding to the stimulation pattern in memory within the implantable device; and
using data stored in the memory to control generation of electrical stimulation to provide the stimulation pattern that includes the pulses with the wave morphology and includes the multiple burst durations and the multiple burst interval sequences.

### Claim 16 (depends on 15)

The method of claim 15, further comprising receiving user input at a user interface, and determining the stimulation pattern based on the user input.

### Claim 17 (depends on 5)

The method of claim 5, wherein the wave morphology includes a morphology that includes harmonic components to mimic naturally-occurring neural activity.

### Claim 18 (depends on 15)

The method of claim 15, wherein the wave morphology includes a morphology selected from the group of morphologies consisting of:
a square wave; and
at least one of a triangle wave or a sinusoidal wave.

### Claim 19

A non-transitory machine-readable medium including instructions, which when executed by an implantable device configured to generate electrical stimulation to provide a stimulation pattern for use to modulate neural activity using at least one electrode, cause the implantable device to:
receive, from another device, information corresponding to the stimulation pattern, wherein the stimulation pattern includes a pattern of bursts with multiple burst durations and multiple burst interval sequences, and the bursts include pulses with a wave morphology, the pattern of bursts with multiple burst durations and multiple burst interval sequences being different from a simple burst pattern of repeated bursts with one burst duration and burst interval;
store data corresponding to the stimulation pattern in memory within the implantable device; and
use the data stored in the memory to control generation of electrical stimulation to provide the stimulation pattern that includes the pulses with the wave morphology and includes the multiple burst durations and the multiple burst interval sequences.

### Claim 20 (depends on 19)

The non-transitory machine-readable medium of claim 19, wherein the instructions include instructions, which when executed by the implantable device, cause the implantable device to control generation of the stimulation pattern according to a schedule stored in memory of the implantable device.
