Transesophageal vagus nerve stimulation

A method comprising:

• generating, by stimulation circuitry, a transesophageal stimulation signal, the transesophageal stimulation signal being at least partially defined by stimulation parameters;
• determining, by processing circuitry and for each of a plurality of different electrode combinations of a plurality of electrodes, a corresponding threshold amplitude value based on at a transesophageal stimulation amplitude that elicits muscular activity in response to delivery of the transesophageal stimulation signal via a corresponding combination of electrodes;
• determining, by the processing circuitry and for each of the plurality of different electrode combinations, a corresponding maximum transesophageal stimulation amplitude value that is below the corresponding threshold amplitude value based on corresponding evoked compound action potentials (ECAPs);
• selecting, by the processing circuitry and as the combination of electrodes, one of the plurality of different electrode combinations that has at least one of a highest ECAP amplitude value or a highest respective maximum transesophageal stimulation amplitude value;
• selecting, by the processing circuitry, the maximum stimulation amplitude value associated with the combination of electrodes;
• determining, by the processing circuitry, at least one of a phase of a cardiac cycle of a patient or a phase of a circadian rhythm of the patient;
• controlling, by the processing circuitry, the stimulation circuitry to generate the transesophageal stimulation signal based at least in part on at least one stimulation parameter or the maximum transesophageal stimulation amplitude such the transesophageal stimulation signal is delivered via the combination of electrodes and that an amplitude of the transesophageal stimulation signal does not exceed the maximum transesophageal stimulation amplitude;
• and
• controlling, by the processing circuitry, the stimulation circuitry to gate the delivery of the transesophageal stimulation signal to be during the at least one of the phase of a cardiac cycle of the patient or the phase of a circadian rhythm of the patient.

A system comprising:

• stimulation circuitry configured to generate a transesophageal stimulation signal;
• memory configured to store stimulation parameters that at least partially define the transesophageal stimulation signal;
• and
• processing circuitry communicatively coupled to the memory, and the stimulation circuitry, the processing circuitry being configured to:
• determine a maximum transesophageal stimulation amplitude value that is below a threshold amplitude value;
• determine a respective maximum transesophageal stimulation amplitude value that is below the threshold amplitude value for each of a plurality of different electrode combinations based on respective evoked compound action potentials (ECAPs);
• select, as a combination of electrodes for delivery of the transesophageal stimulation signal, one of the plurality of different electrode combinations that has at least one of a highest ECAP amplitude value or a highest respective maximum transesophageal stimulation amplitude value;
• and
• control the stimulation circuitry to generate the transesophageal stimulation signal based at least in part on at least one of the stimulation parameters or the maximum transesophageal stimulation amplitude such that an amplitude of the transesophageal stimulation signal does not exceed the maximum transesophageal stimulation amplitude and deliver the transesophageal stimulation signal via the selected one of the plurality of different electrode combination.