Implantable neurostimulators are effective at treating various disorders such as epilepsy and depression. A neurostimulator is implanted in the patient and connected via one or more electrodes to a target nerve, such as the vagus nerve. Current from the electrical signal provided by the neurostimulator or action potentials evoked by the stimulated target nerve can propagate to a non-target nerve (including nerves nearby the target nerve as well as specific non-target fibers within the target nerve) and non-target muscle tissue adjacent to the electrodes. As a result, such nearby tissues may be stimulated thereby resulting in wasted energy that is non-therapeutic and which may in addition cause undesired side effects such as contractions of the muscle tissue. For example, it is possible for vagus nerve stimulation to excite the muscles at or near the patient's vocal cords thereby potentially causing hoarseness. While generally regarded as benign, the excitation of muscle tissue and the resultant hoarseness may be uncomfortable to the patient and is at any rate undesired, wasteful and non-therapeutic. Ameliorating the foregoing problems while improving the efficacy of the underlying therapy provided by the neurostimulator is desirable.
In accordance with at least one embodiment of the invention, an implantable medical device comprises a neurostimulator that provides a first electrical signal to a nerve (e.g., the vagus nerve) in a first, non-refractory period. The first electrical signal is adapted to induce action potentials in one or more target axons (fibers) of the nerve. The neurostimulator also provides a second electrical signal to the nerve during a second period in which one or more of the non-target tissues (e.g. adjacent muscles or non-target nerve fibers) are refractory. The second period may comprise at least a portion of one or both of an absolute refractory period and a relative refractory period for the non-target tissue. The second signal provided to the nerve during the refractory period causes the refractory period of the non-target tissue to be altered, i.e., extended or shortened, depending on the attributes of the second signal. Extending the refractory period ameliorates various side effects that might otherwise occur. Shortening the relative refractory period facilitates additional therapies to be implemented.
In accordance with some embodiments, a method comprises applying a first electrical signal to a nerve to evoke an action potential. As a result, the nerve enters a refractory period in which the nerve is refractory to further induction of action potentials. During the refractory period, the method also comprises providing a second electrical signal to the nerve thereby altering the refractory period.
In accordance with another embodiment, a method comprises applying a first electrical signal to a nerve to evoke an action potential. The first electrical signal or action potential evokes action potentials in non-target tissue. The non-target tissue thereafter enters a refractory period in which the non-target tissue is refractory to further induction of action potentials. During the refractory period, the method further comprises applying a second electrical signal to the nerve thereby altering the refractory period of the non-target tissue.
In accordance with another embodiment, an implantable neurostimulator comprises an electrical signal generator and an electrode coupled to the electrical signal generator. The electrode is adapted to couple to a nerve. The electrical signal generator applies a first electrical signal to a nerve to evoke an action potential. As a result, the nerve enters a refractory period in which the nerve is in a refractory state. During the refractory period, the electrical signal generator provides a second electrical signal to the nerve thereby altering the refractory period of the nerve.
In accordance with yet another embodiment, an implantable neurostimulator comprises an electrical signal generator and an electrode. The electrode is adapted to be coupled to the electrical signal generator and to a nerve to thereby provide therapy to a target nerve fiber. The electrical signal generator applies a first electrical signal to a nerve to evoke an action potential in the target nerve which causes an action potential to be evoked in a non-target nerve fiber or tissue. The non-target nerve fiber or tissue thereby enters a refractory period in which the non-target nerve fiber or tissue is in a refractory state. During the refractory period, the electrical signal generator applies a second electrical signal to the nerve fiber or tissue thereby altering the refractory period of the non-target nerve fiber or tissue.
For a detailed description of exemplary embodiments of the invention, reference will now be made to the accompanying drawings in which:
The following discussion is directed to various embodiments of the invention. Although one or more of these embodiments may be preferred, the embodiments disclosed should not be interpreted, or otherwise used, as limiting the scope of the disclosure, including the claims. In addition, one skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is meant only to be exemplary of that embodiment, and is not intended to limit the scope of the disclosure, including the claims, to that embodiment.
Referring still to
The controller 34 generally assists, controls, and/or programs the SCU 32. Controller 34 preferably comprises a processor 36 such as a low-power, mixed-signal microcontroller. One suitable processor is available from Texas Instruments, Inc., selected from the MSP430F family of processors. Other suitable processors from the PIC1xF family of processors are available from MicroChip Technology. Other suitable processors may be used and/or integrated into the controller 34, although the processor 36 preferably is capable of processing a variety of sensor inputs, uses low power, and operates at a high speed. In general, however, any suitable processor 36 can be used in the controller 34 to implement the functionality performed by the controller 34 as explained herein. It will be appreciated that some features of the controller 34 may also be provided in whole or in part by the SCU 32, and vice versa. Thus, while certain features of preferred embodiments of the present invention may be described as comprising part of the SCU 32, it is not intended thereby to preclude embodiments in which the features are provided by the controller 34. Likewise, certain features described herein as comprising part of the controller 34 are not intended to preclude embodiments in which the features comprise part of the SCU 32.
In the embodiment of
The external programming system 20 can wirelessly transmit programs and configuration data to the IMD 10 for storage in the IMD's memory 40, registers internal to the processor 36, or other storage of the IMD 10.
Like all electrically-excitable tissue, neural tissue, such as the vagus nerve, has an intrinsic property called the “refractory period.” Once a nerve is excited (i.e., an action potential is generated), the nerve enters the refractory period during which time the nerve is resistant to further induction of action potentials, even if another or additional electrical current is applied to the nerve. During this time period, the nerve is said to be “refractory” to an applied electrical signal. In general, action potentials can again be induced in the nerve with an applied electrical signal once the refractory period is over.
As illustrated by
Muscle tissue (e.g., the heart) is also characterized by a refractory period. Different types of muscular and neural tissues have different refractory periods. The refractory period of cardiac tissue tends to be substantially longer than the refractory period of neural tissue. Further, the vagus nerve comprises different types of nerve fibers, e.g., A fibers, B fibers and C fibers, with many subtypes. A and B vagus nerve fibers have larger diameters than C fibers. C fibers tend to have substantially longer refractory periods than A and B fibers, and B fibers have slightly longer refractory periods than A fibers.
Without limiting the scope of this disclosure, Table I below provides exemplary values for the absolute and relative refractory periods of various types of nerves and tissues. In general muscle tissues have substantially longer refractory periods than nerve tissues.
In accordance with various embodiments of the invention, the IMD 10 alters the length of the refractory period and, in some embodiments, specifically the relative refractory period. In some embodiments, the IMD 10 extends the relative refractory period, while in other embodiments, the IMD 10 shortens the relative refractory period. Further still, in some embodiments, the IMD 10 extends the relative refractory period in accordance with some therapies or situations, while shortening the relative refractory in accordance with other therapies or situations. Extending a relative refractory period can be accomplished by providing an electrical signal to the nerve during the relative refractory period at a level low enough so as not to re-stimulate the nerve. Shortening the relative refractory period can be accomplished by providing a signal during the relative refractory period with a polarity opposite to that of the first electrical signal that induced the action potential.
Extending the relative refractory is useful to ameliorate side effects that might otherwise be caused by the IMD 10. For example, action potentials generated by applying a first electrical signal to a vagus nerve of a patient may propagate to adjacent muscle tissues. Such muscle tissues may include muscles adjacent to, or that directly control, the patient's vocal cords. As a result of stimulating the patient's vagus nerve, the patient's vocal cords, or controlling muscles, may be affected possibly resulting in hoarseness or changes to the patient's voice during delivery of a first electrical signal. All tissues stimulated by the first electrical signal, including both target nerve fibers and non-target nerve fibers or muscles, will begin their respective intrinsic refractory periods approximately synchronous with the first electrical signal. However, the difference between intrinsic refractory periods of different tissues may be exploited to ameliorate undesired side effects.
In accordance with at least some embodiments, the current generator 37 of the IMD 10 provides a second electrical signal during the relative refractory period of at least one non-target tissue, such as a particular nerve fiber type, or muscle tissue. The magnitude of the second electrical signal is small enough to prevent additional action potentials from being generated. Instead, the second electrical signal provided to the nerve causes the non-target tissue, which is in a refractory state, to remain in a refractory state, thereby extending the duration of the relative refractory period. By extending the relative refractory period of the non-target tissue, no additional action potentials will be induced that otherwise would propagate to, and stimulate, adjacent tissues. In at least some such embodiments, the relative refractory period is extended as long as the second electrical signal continues to be applied to the nerve.
The magnitude of the second electrical signal used to extend the relative refractory period depends, at least in part, on the point in time during the relative refractory period at which the second electrical signal is first applied to the nerve. The earlier in the relative refractory period that the second electrical signal is applied, the larger the magnitude the second electrical signal needs to be to cause the relative refractory period to be extended. By contrast, the later in the relative refractory period that the current is applied, the smaller the magnitude of the current needs to be to cause the relative refractory period to be extended.
Shortening the relative refractory period of a nerve causes the nerve to be available to be re-stimulated sooner than otherwise would be possible. As a result, therapies are possible in which the nerve can be stimulated a faster rate than without the use of the second electrical signal. Further, as illustrated in
In accordance with at least some embodiments of the invention, the external programming system 20 (
The above discussion is meant to be illustrative of the principles and various embodiments of the present invention. Numerous variations and modifications will become apparent to those skilled in the art once the above disclosure is fully appreciated. It is intended that the following claims be interpreted to embrace all such variations and modifications.
Number | Name | Date | Kind |
---|---|---|---|
3760812 | Timm et al. | Sep 1973 | A |
3796221 | Hagfors | Mar 1974 | A |
4107469 | Jenkins | Aug 1978 | A |
4305402 | Katims | Dec 1981 | A |
4338945 | Kosugi et al. | Jul 1982 | A |
4424812 | Lesnick | Jan 1984 | A |
4431000 | Butler et al. | Feb 1984 | A |
4459989 | Borkan | Jul 1984 | A |
4503863 | Katims | Mar 1985 | A |
4541432 | Molina-Negro et al. | Sep 1985 | A |
4573481 | Bullara | Mar 1986 | A |
4577316 | Schiff | Mar 1986 | A |
4590946 | Loeb | May 1986 | A |
4592339 | Kuzmak et al. | Jun 1986 | A |
4606349 | Livingston et al. | Aug 1986 | A |
4608985 | Crish et al. | Sep 1986 | A |
4612934 | Borkan | Sep 1986 | A |
4625308 | Kim et al. | Nov 1986 | A |
4628942 | Sweeney et al. | Dec 1986 | A |
4640286 | Thomson | Feb 1987 | A |
4649936 | Ungar et al. | Mar 1987 | A |
4702254 | Zabara | Oct 1987 | A |
4793353 | Borkan | Dec 1988 | A |
4867164 | Zabara | Sep 1989 | A |
4920979 | Bullara | May 1990 | A |
4949721 | Toriu et al. | Aug 1990 | A |
4977895 | Tannenbaum | Dec 1990 | A |
5025807 | Zabara | Jun 1991 | A |
5081987 | Nigam | Jan 1992 | A |
5154172 | Terry, Jr. et al. | Oct 1992 | A |
5179950 | Stanislaw | Jan 1993 | A |
5186170 | Varrichio et al. | Feb 1993 | A |
5188104 | Wernicke et al. | Feb 1993 | A |
5205285 | Baker, Jr. | Apr 1993 | A |
5215086 | Terry, Jr. et al. | Jun 1993 | A |
5222494 | Baker, Jr. | Jun 1993 | A |
5231988 | Wernicke et al. | Aug 1993 | A |
5235980 | Varrichio et al. | Aug 1993 | A |
5263480 | Wernicke et al. | Nov 1993 | A |
5269303 | Wernicke et al. | Dec 1993 | A |
5299569 | Wernicke et al. | Apr 1994 | A |
5330507 | Schwartz | Jul 1994 | A |
5330515 | Rutecki et al. | Jul 1994 | A |
5334221 | Bardy | Aug 1994 | A |
5354320 | Schaldach et al. | Oct 1994 | A |
5411531 | Hill et al. | May 1995 | A |
5411540 | Edell et al. | May 1995 | A |
5423872 | Cigaina | Jun 1995 | A |
5507784 | Hill et al. | Apr 1996 | A |
5522862 | Testerman et al. | Jun 1996 | A |
5522865 | Schulman et al. | Jun 1996 | A |
5540730 | Terry, Jr. et al. | Jul 1996 | A |
5540734 | Zabara | Jul 1996 | A |
5571150 | Wernicke et al. | Nov 1996 | A |
5601617 | Loeb et al. | Feb 1997 | A |
5611350 | John | Mar 1997 | A |
5620468 | Mongeon et al. | Apr 1997 | A |
5645570 | Corbucci | Jul 1997 | A |
5651378 | Matheny et al. | Jul 1997 | A |
5658318 | Stroetmann et al. | Aug 1997 | A |
5690681 | Geddes et al. | Nov 1997 | A |
5690688 | Noren et al. | Nov 1997 | A |
5690691 | Chen et al. | Nov 1997 | A |
5700282 | Zabara | Dec 1997 | A |
5702428 | Tippey et al. | Dec 1997 | A |
5702429 | King | Dec 1997 | A |
5707400 | Terry, Jr. et al. | Jan 1998 | A |
5755750 | Petruska et al. | May 1998 | A |
5792212 | Weijand | Aug 1998 | A |
5800474 | Benabid et al. | Sep 1998 | A |
5814092 | King | Sep 1998 | A |
5836994 | Bourgeois | Nov 1998 | A |
5861014 | Familoni | Jan 1999 | A |
5871505 | Adams et al. | Feb 1999 | A |
5913882 | King | Jun 1999 | A |
5916239 | Geddes et al. | Jun 1999 | A |
5928272 | Adkins et al. | Jul 1999 | A |
5941906 | Barreras, Sr. et al. | Aug 1999 | A |
5995868 | Osorio et al. | Nov 1999 | A |
6002966 | Loeb et al. | Dec 1999 | A |
6016449 | Fischell et al. | Jan 2000 | A |
6041258 | Cigaina et al. | Mar 2000 | A |
6083249 | Familoni | Jul 2000 | A |
6101412 | Duhaylongsod | Aug 2000 | A |
6104955 | Bourgeois | Aug 2000 | A |
6104956 | Naritoku et al. | Aug 2000 | A |
6115628 | Stadler et al. | Sep 2000 | A |
6132361 | Epstein et al. | Oct 2000 | A |
6141590 | Renirie et al. | Oct 2000 | A |
6161044 | Silverstone | Dec 2000 | A |
6167311 | Rezai | Dec 2000 | A |
6175764 | Loeb et al. | Jan 2001 | B1 |
6188929 | Giordano | Feb 2001 | B1 |
6219580 | Faltys et al. | Apr 2001 | B1 |
6221908 | Kilgard et al. | Apr 2001 | B1 |
6238423 | Bardy | May 2001 | B1 |
6249704 | Maltan et al. | Jun 2001 | B1 |
6253109 | Gielen | Jun 2001 | B1 |
6266564 | Hill et al. | Jul 2001 | B1 |
6269270 | Boveja | Jul 2001 | B1 |
6295472 | Rubinstein et al. | Sep 2001 | B1 |
6304775 | Iasemidis et al. | Oct 2001 | B1 |
6308102 | Sieracki | Oct 2001 | B1 |
6324421 | Stadler et al. | Nov 2001 | B1 |
6327503 | Familoni | Dec 2001 | B1 |
6339725 | Naritoku et al. | Jan 2002 | B1 |
6341236 | Osorio et al. | Jan 2002 | B1 |
6353762 | Baudino et al. | Mar 2002 | B1 |
6356788 | Boveja | Mar 2002 | B2 |
6358203 | Bardy | Mar 2002 | B2 |
6366813 | DiLorenzo | Apr 2002 | B1 |
6366814 | Boveja | Apr 2002 | B1 |
6374140 | Rise | Apr 2002 | B1 |
6381493 | Stadler et al. | Apr 2002 | B1 |
6381496 | Meadows et al. | Apr 2002 | B1 |
6381499 | Taylor et al. | Apr 2002 | B1 |
6418344 | Rezai et al. | Jul 2002 | B1 |
6425852 | Epstein et al. | Jul 2002 | B1 |
6438423 | Rezai et al. | Aug 2002 | B1 |
6449512 | Boveja | Sep 2002 | B1 |
6453199 | Kobozev | Sep 2002 | B1 |
6459936 | Fischell et al. | Oct 2002 | B2 |
6463328 | John | Oct 2002 | B1 |
6466822 | Pless | Oct 2002 | B1 |
6473639 | Fischell et al. | Oct 2002 | B1 |
6473644 | Terry, Jr. et al. | Oct 2002 | B1 |
6477417 | Levine | Nov 2002 | B1 |
6477418 | Plicchi et al. | Nov 2002 | B2 |
6480743 | Kirkpatrick et al. | Nov 2002 | B1 |
6484132 | Hively et al. | Nov 2002 | B1 |
6487446 | Hill et al. | Nov 2002 | B1 |
6505074 | Boveja et al. | Jan 2003 | B2 |
6522928 | Whitehurst et al. | Feb 2003 | B2 |
6532388 | Hill et al. | Mar 2003 | B1 |
6549804 | Osorio et al. | Apr 2003 | B1 |
6556868 | Naritoku et al. | Apr 2003 | B2 |
6564102 | Boveja | May 2003 | B1 |
6565503 | Leysieffer et al. | May 2003 | B2 |
6579280 | Kovach et al. | Jun 2003 | B1 |
6587719 | Barrett et al. | Jul 2003 | B1 |
6587724 | Mann | Jul 2003 | B2 |
6587726 | Lurie et al. | Jul 2003 | B2 |
6587727 | Osorio et al. | Jul 2003 | B2 |
6591138 | Fischell et al. | Jul 2003 | B1 |
6594524 | Esteller et al. | Jul 2003 | B2 |
6600953 | Flesler et al. | Jul 2003 | B2 |
6609025 | Barrett et al. | Aug 2003 | B2 |
6609030 | Rezai et al. | Aug 2003 | B1 |
6609031 | Law et al. | Aug 2003 | B1 |
6610713 | Tracey | Aug 2003 | B2 |
6611715 | Boveja | Aug 2003 | B1 |
6612983 | Marchal | Sep 2003 | B1 |
6615081 | Boveja | Sep 2003 | B1 |
6615084 | Cigaina | Sep 2003 | B1 |
6615085 | Boveja | Sep 2003 | B1 |
6622038 | Barrett et al. | Sep 2003 | B2 |
6622041 | Terry, Jr. et al. | Sep 2003 | B2 |
6622047 | Barrett et al. | Sep 2003 | B2 |
6628987 | Hill et al. | Sep 2003 | B1 |
6656960 | Puskas | Dec 2003 | B2 |
6662053 | Borkan | Dec 2003 | B2 |
6668191 | Boveja | Dec 2003 | B1 |
6671547 | Lyster et al. | Dec 2003 | B2 |
6671555 | Gielen et al. | Dec 2003 | B2 |
6671556 | Osorio et al. | Dec 2003 | B2 |
6684104 | Gordon et al. | Jan 2004 | B2 |
6684105 | Cohen et al. | Jan 2004 | B2 |
6690973 | Hill et al. | Feb 2004 | B2 |
6690974 | Archer et al. | Feb 2004 | B2 |
6701187 | Bornzin et al. | Mar 2004 | B1 |
6708064 | Rezai | Mar 2004 | B2 |
6721603 | Zabara et al. | Apr 2004 | B2 |
6731979 | MacDonald | May 2004 | B2 |
6731986 | Mann | May 2004 | B2 |
6754536 | Swoyer et al. | Jun 2004 | B2 |
6760626 | Boveja | Jul 2004 | B1 |
6764498 | Mische | Jul 2004 | B2 |
6768969 | Nikitin et al. | Jul 2004 | B1 |
6775573 | Schuler et al. | Aug 2004 | B2 |
6793670 | Osorio et al. | Sep 2004 | B2 |
6819956 | DiLorenzo | Nov 2004 | B2 |
6826428 | Chen et al. | Nov 2004 | B1 |
6832114 | Whitehurst et al. | Dec 2004 | B1 |
6853862 | Marchal et al. | Feb 2005 | B1 |
6885888 | Rezai | Apr 2005 | B2 |
6895278 | Gordon | May 2005 | B1 |
6904390 | Nikitin et al. | Jun 2005 | B2 |
6907295 | Gross et al. | Jun 2005 | B2 |
6920357 | Osorio et al. | Jul 2005 | B2 |
6934580 | Osorio et al. | Aug 2005 | B1 |
6944501 | Pless | Sep 2005 | B1 |
6944503 | Crowe et al. | Sep 2005 | B2 |
6961618 | Osorio et al. | Nov 2005 | B2 |
7006859 | Osorio et al. | Feb 2006 | B1 |
7006872 | Gielen et al. | Feb 2006 | B2 |
7050856 | Stypulkowski | May 2006 | B2 |
7054686 | MacDonald | May 2006 | B2 |
7146217 | Firlik et al. | Dec 2006 | B2 |
7167750 | Knudson et al. | Jan 2007 | B2 |
7177678 | Osorio et al. | Feb 2007 | B1 |
7188053 | Nikitin et al. | Mar 2007 | B2 |
7204833 | Osorio et al. | Apr 2007 | B1 |
7209787 | DiLorenzo | Apr 2007 | B2 |
7231254 | DiLorenzo | Jun 2007 | B2 |
7236830 | Gliner | Jun 2007 | B2 |
7236831 | Firlik et al. | Jun 2007 | B2 |
7242983 | Frei et al. | Jul 2007 | B2 |
7242984 | DiLorenzo | Jul 2007 | B2 |
7340302 | Falkenberg et al. | Mar 2008 | B1 |
20010034541 | Lyden | Oct 2001 | A1 |
20010037220 | Merry et al. | Nov 2001 | A1 |
20020052539 | Haller et al. | May 2002 | A1 |
20020065509 | Lebel et al. | May 2002 | A1 |
20020072782 | Osorio et al. | Jun 2002 | A1 |
20020082480 | Riff et al. | Jun 2002 | A1 |
20020099412 | Fischell et al. | Jul 2002 | A1 |
20020099417 | Naritoku et al. | Jul 2002 | A1 |
20020116030 | Rezai | Aug 2002 | A1 |
20020120310 | Linden et al. | Aug 2002 | A1 |
20020133204 | Hrdlicka | Sep 2002 | A1 |
20020143368 | Bakels et al. | Oct 2002 | A1 |
20020151939 | Rezai | Oct 2002 | A1 |
20020153901 | Davis et al. | Oct 2002 | A1 |
20020188214 | Misczynski et al. | Dec 2002 | A1 |
20030028226 | Thompson et al. | Feb 2003 | A1 |
20030055457 | MacDonald | Mar 2003 | A1 |
20030074032 | Gliner | Apr 2003 | A1 |
20030083716 | Nicolelis et al. | May 2003 | A1 |
20030083727 | Casavant et al. | May 2003 | A1 |
20030088274 | Gliner et al. | May 2003 | A1 |
20030095648 | Kaib et al. | May 2003 | A1 |
20030097161 | Firlik et al. | May 2003 | A1 |
20030109903 | Berrang et al. | Jun 2003 | A1 |
20030125786 | Gliner et al. | Jul 2003 | A1 |
20030130706 | Sheffield et al. | Jul 2003 | A1 |
20030144711 | Pless et al. | Jul 2003 | A1 |
20030144829 | Geatz et al. | Jul 2003 | A1 |
20030181954 | Rezai | Sep 2003 | A1 |
20030181958 | Dobak | Sep 2003 | A1 |
20030181959 | Dobak | Sep 2003 | A1 |
20030208212 | Cigaina | Nov 2003 | A1 |
20030210147 | Humbard | Nov 2003 | A1 |
20030212440 | Boveja | Nov 2003 | A1 |
20030236558 | Whitehurst et al. | Dec 2003 | A1 |
20040006278 | Webb et al. | Jan 2004 | A1 |
20040015205 | Whitehurst et al. | Jan 2004 | A1 |
20040036377 | Mezinis | Feb 2004 | A1 |
20040039424 | Merritt et al. | Feb 2004 | A1 |
20040088024 | Firlik et al. | May 2004 | A1 |
20040102811 | Schwartz et al. | May 2004 | A1 |
20040111139 | McCreery | Jun 2004 | A1 |
20040112894 | Varma | Jun 2004 | A1 |
20040122484 | Hatlestad et al. | Jun 2004 | A1 |
20040122485 | Stahmann et al. | Jun 2004 | A1 |
20040122489 | Mazar et al. | Jun 2004 | A1 |
20040133119 | Osorio et al. | Jul 2004 | A1 |
20040138516 | Osorio et al. | Jul 2004 | A1 |
20040138517 | Osorio et al. | Jul 2004 | A1 |
20040138518 | Rise et al. | Jul 2004 | A1 |
20040138647 | Osorio et al. | Jul 2004 | A1 |
20040138711 | Osorio et al. | Jul 2004 | A1 |
20040147969 | Mann et al. | Jul 2004 | A1 |
20040147992 | Bluger et al. | Jul 2004 | A1 |
20040153129 | Pless et al. | Aug 2004 | A1 |
20040158119 | Osorio et al. | Aug 2004 | A1 |
20040158165 | Yonce et al. | Aug 2004 | A1 |
20040167583 | Knudson et al. | Aug 2004 | A1 |
20040167587 | Thompson | Aug 2004 | A1 |
20040172085 | Knudson et al. | Sep 2004 | A1 |
20040172088 | Knudson et al. | Sep 2004 | A1 |
20040172089 | Whitehurst et al. | Sep 2004 | A1 |
20040172091 | Rezai | Sep 2004 | A1 |
20040172094 | Cohen et al. | Sep 2004 | A1 |
20040176812 | Knudson et al. | Sep 2004 | A1 |
20040176831 | Gliner et al. | Sep 2004 | A1 |
20040193231 | David et al. | Sep 2004 | A1 |
20040199146 | Rogers et al. | Oct 2004 | A1 |
20040199187 | Loughran | Oct 2004 | A1 |
20040199212 | Fischell et al. | Oct 2004 | A1 |
20040210270 | Erickson | Oct 2004 | A1 |
20040210274 | Bauhahn et al. | Oct 2004 | A1 |
20040249302 | Donoghue et al. | Dec 2004 | A1 |
20040249416 | Yun et al. | Dec 2004 | A1 |
20040260346 | Overall et al. | Dec 2004 | A1 |
20040263172 | Gray et al. | Dec 2004 | A1 |
20050004615 | Sanders | Jan 2005 | A1 |
20050004621 | Boveja et al. | Jan 2005 | A1 |
20050010262 | Rezai et al. | Jan 2005 | A1 |
20050015128 | Rezai et al. | Jan 2005 | A1 |
20050016657 | Bluger | Jan 2005 | A1 |
20050020887 | Goldberg | Jan 2005 | A1 |
20050021092 | Yun et al. | Jan 2005 | A1 |
20050021103 | DiLorenzo | Jan 2005 | A1 |
20050021104 | DiLorenzo | Jan 2005 | A1 |
20050021105 | Firlik et al. | Jan 2005 | A1 |
20050021106 | Firlik et al. | Jan 2005 | A1 |
20050021107 | Firlik et al. | Jan 2005 | A1 |
20050021118 | Genau et al. | Jan 2005 | A1 |
20050027284 | Lozano et al. | Feb 2005 | A1 |
20050028026 | Shirley et al. | Feb 2005 | A1 |
20050033378 | Sheffield et al. | Feb 2005 | A1 |
20050033379 | Lozano et al. | Feb 2005 | A1 |
20050038326 | Mathur | Feb 2005 | A1 |
20050038484 | Knudson et al. | Feb 2005 | A1 |
20050049515 | Misczynski et al. | Mar 2005 | A1 |
20050049655 | Boveja et al. | Mar 2005 | A1 |
20050060007 | Goetz | Mar 2005 | A1 |
20050060008 | Goetz | Mar 2005 | A1 |
20050060009 | Goetz | Mar 2005 | A1 |
20050060010 | Goetz | Mar 2005 | A1 |
20050065562 | Rezai | Mar 2005 | A1 |
20050065573 | Rezai | Mar 2005 | A1 |
20050065574 | Rezai | Mar 2005 | A1 |
20050065575 | Dobak | Mar 2005 | A1 |
20050070971 | Fowler et al. | Mar 2005 | A1 |
20050075679 | Gliner et al. | Apr 2005 | A1 |
20050075680 | Lowry et al. | Apr 2005 | A1 |
20050075681 | Rezai et al. | Apr 2005 | A1 |
20050075691 | Phillips et al. | Apr 2005 | A1 |
20050075701 | Shafer | Apr 2005 | A1 |
20050075702 | Shafer | Apr 2005 | A1 |
20050088145 | Loch | Apr 2005 | A1 |
20050101873 | Misczynski et al. | May 2005 | A1 |
20050102002 | Salo et al. | May 2005 | A1 |
20050107753 | Rezai et al. | May 2005 | A1 |
20050107842 | Rezai | May 2005 | A1 |
20050107858 | Bulger | May 2005 | A1 |
20050113705 | Fischell et al. | May 2005 | A1 |
20050113744 | Donoghue et al. | May 2005 | A1 |
20050119703 | DiLorenzo | Jun 2005 | A1 |
20050124901 | Misczynski et al. | Jun 2005 | A1 |
20050131467 | Boveja et al. | Jun 2005 | A1 |
20050131485 | Knudson et al. | Jun 2005 | A1 |
20050131486 | Boveja et al. | Jun 2005 | A1 |
20050131493 | Boveja et al. | Jun 2005 | A1 |
20050131506 | Rezai et al. | Jun 2005 | A1 |
20050137480 | Alt et al. | Jun 2005 | A1 |
20050143781 | Carbunaru et al. | Jun 2005 | A1 |
20050143786 | Boveja et al. | Jun 2005 | A1 |
20050148893 | Misczynski et al. | Jul 2005 | A1 |
20050148894 | Misczynski et al. | Jul 2005 | A1 |
20050148895 | Misczynski et al. | Jul 2005 | A1 |
20050153885 | Yun et al. | Jul 2005 | A1 |
20050154425 | Boveja et al. | Jul 2005 | A1 |
20050154435 | Stern et al. | Jul 2005 | A1 |
20050159789 | Brockway et al. | Jul 2005 | A1 |
20050161052 | Rezai et al. | Jul 2005 | A1 |
20050165458 | Boveja et al. | Jul 2005 | A1 |
20050177192 | Rezai et al. | Aug 2005 | A1 |
20050177200 | George et al. | Aug 2005 | A1 |
20050177206 | North et al. | Aug 2005 | A1 |
20050182389 | LaPorte et al. | Aug 2005 | A1 |
20050187590 | Boveja et al. | Aug 2005 | A1 |
20050187593 | Housworth et al. | Aug 2005 | A1 |
20050187796 | Rosenfeld et al. | Aug 2005 | A1 |
20050192644 | Boveja et al. | Sep 2005 | A1 |
20050197590 | Osorio et al. | Sep 2005 | A1 |
20050222631 | Dalal et al. | Oct 2005 | A1 |
20050228693 | Webb et al. | Oct 2005 | A1 |
20050240246 | Lee et al. | Oct 2005 | A1 |
20050245944 | Rezai | Nov 2005 | A1 |
20050245971 | Brockway et al. | Nov 2005 | A1 |
20050245990 | Roberson | Nov 2005 | A1 |
20050261542 | Riehl | Nov 2005 | A1 |
20050267550 | Hess et al. | Dec 2005 | A1 |
20050272280 | Osypka | Dec 2005 | A1 |
20050277872 | Colby et al. | Dec 2005 | A1 |
20050277998 | Tracey et al. | Dec 2005 | A1 |
20050283200 | Rezai et al. | Dec 2005 | A1 |
20050283201 | Machado et al. | Dec 2005 | A1 |
20050283208 | Von Arx et al. | Dec 2005 | A1 |
20050288600 | Zhang et al. | Dec 2005 | A1 |
20050288736 | Persen et al. | Dec 2005 | A1 |
20050288760 | Machado et al. | Dec 2005 | A1 |
20060009815 | Boveja | Jan 2006 | A1 |
20060020292 | Goetz et al. | Jan 2006 | A1 |
20060020491 | Mongeon et al. | Jan 2006 | A1 |
20060041222 | Dewing et al. | Feb 2006 | A1 |
20060041223 | Dewing et al. | Feb 2006 | A1 |
20060041287 | Dewing et al. | Feb 2006 | A1 |
20060047205 | Ludomirsky et al. | Mar 2006 | A1 |
20060052843 | Elsner et al. | Mar 2006 | A1 |
20060058597 | Machado et al. | Mar 2006 | A1 |
20060064133 | Von Arx et al. | Mar 2006 | A1 |
20060064134 | Mazar et al. | Mar 2006 | A1 |
20060064143 | Von Arx et al. | Mar 2006 | A1 |
20060069322 | Zhang et al. | Mar 2006 | A1 |
20060074450 | Boveja | Apr 2006 | A1 |
20060079936 | Boveja | Apr 2006 | A1 |
20060079942 | Deno et al. | Apr 2006 | A1 |
20060079945 | Libbus | Apr 2006 | A1 |
20060085046 | Rezai et al. | Apr 2006 | A1 |
20060094971 | Drew | May 2006 | A1 |
20060095081 | Zhou et al. | May 2006 | A1 |
20060100667 | Machado et al. | May 2006 | A1 |
20060106430 | Fowler et al. | May 2006 | A1 |
20060106431 | Wyler et al. | May 2006 | A1 |
20060111644 | Guttag et al. | May 2006 | A1 |
20060122525 | Shusterman | Jun 2006 | A1 |
20060122667 | Chavan et al. | Jun 2006 | A1 |
20060122864 | Gottesman et al. | Jun 2006 | A1 |
20060135877 | Giftakis et al. | Jun 2006 | A1 |
20060135881 | Giftakis et al. | Jun 2006 | A1 |
20060155495 | Osorio et al. | Jul 2006 | A1 |
20060161459 | Rosenfeld et al. | Jul 2006 | A9 |
20060167497 | Armstrong et al. | Jul 2006 | A1 |
20060173493 | Armstrong et al. | Aug 2006 | A1 |
20060173522 | Osorio | Aug 2006 | A1 |
20060190056 | Fowler et al. | Aug 2006 | A1 |
20060195155 | Firlik et al. | Aug 2006 | A1 |
20060195163 | KenKnight et al. | Aug 2006 | A1 |
20060200206 | Firlik et al. | Sep 2006 | A1 |
20060212091 | Lozano et al. | Sep 2006 | A1 |
20060217780 | Gliner et al. | Sep 2006 | A1 |
20060220839 | Fifolt et al. | Oct 2006 | A1 |
20060224067 | Giftakis et al. | Oct 2006 | A1 |
20060224191 | DiLorenzo | Oct 2006 | A1 |
20060241697 | Libbus et al. | Oct 2006 | A1 |
20060241725 | Libbus et al. | Oct 2006 | A1 |
20060247698 | Burnes et al. | Nov 2006 | A1 |
20060253164 | Zhang et al. | Nov 2006 | A1 |
20060253168 | Wyler et al. | Nov 2006 | A1 |
20060253169 | Wyler et al. | Nov 2006 | A1 |
20060253170 | Wyler et al. | Nov 2006 | A1 |
20060253171 | Wyler et al. | Nov 2006 | A1 |
20060259095 | Wyler et al. | Nov 2006 | A1 |
20060264730 | Stivoric et al. | Nov 2006 | A1 |
20060265018 | Smith et al. | Nov 2006 | A1 |
20060271409 | Rosenfeld et al. | Nov 2006 | A1 |
20060293720 | DiLorenzo | Dec 2006 | A1 |
20070027486 | Armstrong et al. | Feb 2007 | A1 |
20070032734 | Najafi et al. | Feb 2007 | A1 |
20070032834 | Gliner et al. | Feb 2007 | A1 |
20070038262 | Kieval et al. | Feb 2007 | A1 |
20070043392 | Gliner et al. | Feb 2007 | A1 |
20070055320 | Weinand et al. | Mar 2007 | A1 |
20070073150 | Gopalsami et al. | Mar 2007 | A1 |
20070073346 | Corbucci et al. | Mar 2007 | A1 |
20070073355 | DiLorenzo | Mar 2007 | A1 |
20070078491 | Siejko et al. | Apr 2007 | A1 |
20070088403 | Wyler et al. | Apr 2007 | A1 |
20070088404 | Wyler et al. | Apr 2007 | A1 |
20070088405 | Jacobson et al. | Apr 2007 | A1 |
20070100278 | Frei et al. | May 2007 | A1 |
20070100397 | Seeberger et al. | May 2007 | A1 |
20070100398 | Sloan | May 2007 | A1 |
20070112393 | Gliner et al. | May 2007 | A1 |
20070123946 | Masoud | May 2007 | A1 |
20070135855 | Foshee et al. | Jun 2007 | A1 |
20070142862 | DiLorenzo | Jun 2007 | A1 |
20070142873 | Esteller et al. | Jun 2007 | A1 |
20070149952 | Bland et al. | Jun 2007 | A1 |
20070150011 | Meyer et al. | Jun 2007 | A1 |
20070150014 | Kramer et al. | Jun 2007 | A1 |
20070150024 | Leyde et al. | Jun 2007 | A1 |
20070150025 | DiLorenzo et al. | Jun 2007 | A1 |
20070156179 | Karashurov | Jul 2007 | A1 |
20070156450 | Roehm et al. | Jul 2007 | A1 |
20070156626 | Roehm et al. | Jul 2007 | A1 |
20070161919 | DiLorenzo | Jul 2007 | A1 |
20070162086 | DiLorenzo | Jul 2007 | A1 |
20070167991 | DiLorenzo | Jul 2007 | A1 |
20070173901 | Reeve | Jul 2007 | A1 |
20070179534 | Firlik et al. | Aug 2007 | A1 |
20070179558 | Gliner et al. | Aug 2007 | A1 |
20070179584 | Gliner | Aug 2007 | A1 |
20070203548 | Pawelzik et al. | Aug 2007 | A1 |
20070208212 | DiLorenzo | Sep 2007 | A1 |
20070208390 | Von Arx et al. | Sep 2007 | A1 |
20070213785 | Osorio et al. | Sep 2007 | A1 |
20070233192 | Craig | Oct 2007 | A1 |
20070238939 | Giftakis et al. | Oct 2007 | A1 |
20070239210 | Libbus et al. | Oct 2007 | A1 |
20070239211 | Lorincz et al. | Oct 2007 | A1 |
20070239220 | Greenhut et al. | Oct 2007 | A1 |
20070244407 | Osorio | Oct 2007 | A1 |
20070249953 | Frei et al. | Oct 2007 | A1 |
20070249954 | Virag et al. | Oct 2007 | A1 |
20070250130 | Ball et al. | Oct 2007 | A1 |
20070250145 | Kraus et al. | Oct 2007 | A1 |
20070255147 | Drew et al. | Nov 2007 | A1 |
20070255155 | Drew et al. | Nov 2007 | A1 |
20070255330 | Lee et al. | Nov 2007 | A1 |
20070255337 | Lu | Nov 2007 | A1 |
20070260147 | Giftakis et al. | Nov 2007 | A1 |
20070260289 | Giftakis et al. | Nov 2007 | A1 |
20070265489 | Fowler et al. | Nov 2007 | A1 |
20070265508 | Sheikhzadeh-Nadjar et al. | Nov 2007 | A1 |
20070265536 | Giftakis et al. | Nov 2007 | A1 |
20070272260 | Nikitin et al. | Nov 2007 | A1 |
20070282177 | Pilz | Dec 2007 | A1 |
20070287931 | DiLorenzo | Dec 2007 | A1 |
20070288072 | Pascual-Leone et al. | Dec 2007 | A1 |
20070299349 | Alt et al. | Dec 2007 | A1 |
20070299473 | Matos | Dec 2007 | A1 |
20070299480 | Hill | Dec 2007 | A1 |
20080015651 | Ettori et al. | Jan 2008 | A1 |
20080015652 | Maile et al. | Jan 2008 | A1 |
20080021332 | Brainard, III | Jan 2008 | A1 |
20080021341 | Harris et al. | Jan 2008 | A1 |
20080021517 | Dietrich | Jan 2008 | A1 |
20080021520 | Dietrich | Jan 2008 | A1 |
20080027347 | Harris et al. | Jan 2008 | A1 |
20080027348 | Harris et al. | Jan 2008 | A1 |
20080027515 | Harris et al. | Jan 2008 | A1 |
20080033502 | Harris et al. | Feb 2008 | A1 |
20080033503 | Fowler et al. | Feb 2008 | A1 |
20080033508 | Frei et al. | Feb 2008 | A1 |
20080039895 | Fowler et al. | Feb 2008 | A1 |
20080046035 | Fowler et al. | Feb 2008 | A1 |
20080046037 | Haubrich et al. | Feb 2008 | A1 |
20080046038 | Hill et al. | Feb 2008 | A1 |
20080051852 | Dietrich et al. | Feb 2008 | A1 |
20080058884 | Matos | Mar 2008 | A1 |
20080064934 | Frei et al. | Mar 2008 | A1 |
20080071323 | Lowry et al. | Mar 2008 | A1 |
20080077028 | Schaldach et al. | Mar 2008 | A1 |
20080081962 | Miller et al. | Apr 2008 | A1 |
20080082132 | Annest et al. | Apr 2008 | A1 |
20080103548 | Fowler et al. | May 2008 | A1 |
20080114417 | Leyde | May 2008 | A1 |
20080119900 | DiLorenzo | May 2008 | A1 |
20080125820 | Stahmann et al. | May 2008 | A1 |
20080139870 | Gliner et al. | Jun 2008 | A1 |
20080146890 | LeBoeuf et al. | Jun 2008 | A1 |
20080146959 | Sheffield et al. | Jun 2008 | A1 |
20080161712 | Leyde | Jul 2008 | A1 |
20080161713 | Leyde et al. | Jul 2008 | A1 |
20080161879 | Firlik et al. | Jul 2008 | A1 |
20080161880 | Firlik et al. | Jul 2008 | A1 |
20080161881 | Firlik et al. | Jul 2008 | A1 |
20080161882 | Firlik et al. | Jul 2008 | A1 |
20080183096 | Snyder et al. | Jul 2008 | A1 |
20080183097 | Leyde et al. | Jul 2008 | A1 |
20080183245 | Van Oort et al. | Jul 2008 | A1 |
20080195175 | Balzer et al. | Aug 2008 | A1 |
20080200925 | Johnson et al. | Aug 2008 | A1 |
20080208013 | Zhang et al. | Aug 2008 | A1 |
20080208074 | Snyder et al. | Aug 2008 | A1 |
20080208285 | Fowler et al. | Aug 2008 | A1 |
20080208291 | Leyde et al. | Aug 2008 | A1 |
20080208781 | Snyder | Aug 2008 | A1 |
20080215112 | Firlik et al. | Sep 2008 | A1 |
20080215114 | Stuerzinger et al. | Sep 2008 | A1 |
20080221644 | Vallapureddy et al. | Sep 2008 | A1 |
20080234598 | Snyder et al. | Sep 2008 | A1 |
20080249591 | Gaw et al. | Oct 2008 | A1 |
20080255582 | Harris | Oct 2008 | A1 |
20090054795 | Misczynski et al. | Feb 2009 | A1 |
20090076567 | Fowler et al. | Mar 2009 | A1 |
20090318779 | Tran | Dec 2009 | A1 |
Number | Date | Country |
---|---|---|
2339971 | Jun 2004 | CA |
0402683 | Dec 1990 | EP |
0713714 | May 1996 | EP |
1139861 | Dec 1999 | EP |
1070518 | Jan 2001 | EP |
0944411 | Apr 2001 | EP |
1145736 | Oct 2001 | EP |
1483020 | Dec 2004 | EP |
1486232 | Dec 2004 | EP |
1595497 | Nov 2005 | EP |
1120130 | Dec 2005 | EP |
1647300 | Apr 2006 | EP |
1202775 | Sep 2006 | EP |
2026870 | Feb 1980 | GB |
2079610 | Jan 1982 | GB |
9302744 | Feb 1993 | WO |
9417771 | Aug 1994 | WO |
0064336 | Nov 2000 | WO |
0108749 | Feb 2001 | WO |
0064336 | Jun 2002 | WO |
03085546 | Oct 2003 | WO |
2004036377 | Apr 2004 | WO |
2004064918 | Aug 2004 | WO |
2004069330 | Aug 2004 | WO |
2004071575 | Aug 2004 | WO |
2004075982 | Sep 2004 | WO |
2004112894 | Dec 2004 | WO |
2005007120 | Jan 2005 | WO |
2005007232 | Jan 2005 | WO |
2005028026 | Mar 2005 | WO |
2005053788 | Jun 2005 | WO |
2005067599 | Jul 2005 | WO |
2005101282 | Oct 2005 | WO |
2006014760 | Feb 2006 | WO |
2006019822 | Feb 2006 | WO |
2006050144 | May 2006 | WO |
2006122148 | Nov 2006 | WO |
2007066343 | Jun 2007 | WO |
2007072425 | Jun 2007 | WO |
2007124126 | Nov 2007 | WO |
2007124190 | Nov 2007 | WO |
2007124192 | Nov 2007 | WO |
2007142523 | Dec 2007 | WO |
Number | Date | Country | |
---|---|---|---|
20080103532 A1 | May 2008 | US |