Electromyographic lead positioning and stimulation titration in a nerve stimulation system for treatment of overactive bladder

A system for improved positioning of an implantable lead in a patient, the system comprising:

• an electromyography (EMG) and stimulation clinician programmer;
• an implantable lead coupleable to the clinician programmer, wherein the implantable lead comprises at least four electrodes;
• wherein the clinician programmer is configured to deliver one or more first test stimulations at one or more stimulation amplitude levels and for a period of time to a nerve tissue of the patient via a principal electrode of the implantable lead,
• wherein the clinician programmer is configured to monitor a stimulation-induced EMG motor response as the one or more first test stimulations are delivered until a desired stimulation-induced EMG motor response is observed, and record a first stimulation amplitude level in response to the desired stimulation-induced EMG motor response being observed;
• wherein the principal electrode is selected from the at least four electrodes of the implantable lead,
• wherein the clinician programmer is configured to deliver second test stimulations at a same stimulation amplitude level as the first stimulation amplitude level for a same period of time sequentially to each of the at least four electrodes of the implantable lead, and the clinician programmer is configured to monitor the stimulation-induced EMG motor response with the clinician programmer for the second test stimulations as sensed via at least one EMG sensing electrode positionable on a skin surface or within the patient so as to facilitate positioning of the implantable lead at a target stimulation region.

A system for improved positioning of an implantable lead in a patient, the system comprising:

• an electromyography (EMG) and stimulation clinician programmer;
• an implantable lead coupleable to the clinician programmer, wherein the implantable lead comprises at least four electrodes;
• at least one EMG sensing electrode minimally invasively positionable on a skin surface or within the patient, the EMG sensing electrode coupleable to the clinician programmer;
• wherein the clinician programmer is configured to deliver one or more first test stimulations at one or more stimulation amplitude levels and for a period of time to a nerve tissue of the patient with a principal electrode of the implantable lead,
• wherein the clinician programmer is configured to monitor a stimulation-induced EMG motor response as the one or more first test stimulations are delivered until a desired stimulation-induced EMG motor response is observed, and record a first stimulation amplitude level in response to the desired stimulation-induced EMG motor response being observed;
• wherein the principal electrode is selected from the at least four electrodes of the implantable lead,
• wherein the clinician programmer is configured to deliver second test stimulations at a same stimulation amplitude level as the first stimulation amplitude level for a same period of time sequentially to each of the at least four electrodes of the implantable lead, and the clinician programmer is configured to monitor the stimulation-induced EMG motor response with the clinician programmer for the second test stimulations as sensed via the at least one EMG sensing electrode so as to facilitate positioning of the implantable lead at a target stimulation region.