Electromyographic Lead Positioning and Stimulation Titration in a Nerve Stimulation System for Treatment of Overactive Bladder

摘要

The present invention provides improved methods for positioning of an implantable lead in a patient with an integrated EMG and stimulation clinician programmer. The integrated clinician programmer is coupled to the implantable lead, wherein the implantable lead comprises at least four electrodes, and to at least one EMG sensing electrode minimally invasively positioned on a skin surface or within the patient. The method comprises delivering a test stimulation at a stimulation amplitude level from the integrated clinician programmer to a nerve tissue of the patient with a principal electrode of the implantable lead. Test stimulations are delivered at a same stimulation amplitude level for a same period of time sequentially to each of the four electrodes of the implantable lead. A stimulation-induced EMG motor response is recorded with the integrated clinician programmer for each test stimulation on each electrode of the implantable lead via the at least one pair of EMG sensing electrodes so as to facilitate initial positioning of the implantable lead at a target stimulation region.

主权项

1. A method for improved positioning of an implantable neurostimulation lead in a patient with an integrated electromyography (EMG) and stimulation clinician programmer coupled to the implantable lead for treatment of overactive bladder and/or fecal incontinence, wherein the implantable lead comprises at least four neurostimulation electrodes and the integrated clinician programmer is further coupled to at least one EMG sensing electrode minimally invasively positioned on a skin surface or within the patient, the method comprising:
delivering a single test stimulation at a stimulation amplitude level from the integrated clinician programmer to a nerve tissue of the patient with a principal electrode of the implantable lead, wherein the principal electrode is selected from the at least four neurostimulation electrodes of the implantable lead; delivering a single test stimulations at a same stimulation amplitude level for a same period of time sequentially to each remaining electrode of the at least four electrodes of the implantable lead; and recording a stimulation-induced EMG motor response with the integrated clinician programmer for each test stimulation on each electrode of the implantable lead via the at least one EMG sensing electrode so as to facilitate positioning of the implantable lead at a target stimulation region for treatment of overactive bladder and/or fecal incontinence.