Programmable autotitrating of electrical parameters of implantable medical device

Abstract

We report a method of automatically titrating an electrical therapy administered to a patient by an implanted medical device to a target dosage, comprising programming the medical device with a programmed electrical therapy comprising a first target value for a first therapy parameter; programming at least one titration parameter for automatically adjusting the first therapy parameter from a first value to the first target value over a titration time period initiating the electrical therapy, wherein the first therapy parameter comprises said first value; and automatically titrating the electrical therapy by making a plurality of adjustments to the value of the first therapy parameter, whereby the first electrical therapy parameter is changed from the first value to the first target value according to a titration function. We also report a medical device system configured to implement the method.

What is claimed: 
     
         1 . A method of treating a medical condition of a patient via an implantable medical device comprising:
 initiating via one or more processors of the implantable medical device a titration period for a first therapy with a first treatment period based on an input obtained from the patient, the first therapy including an electrical stimulation with one or more parameters;   initiating a modification procedure of one or more values associated with the one or more parameters during the titration period; and   initiating the first therapy for the first treatment period based on one or more parameters being tolerated by the patient or reaching one or more target values.   
     
     
         2 . The method of  claim 1 , further comprising initiating a second titration period for a second therapy with a second treatment period. 
     
     
         3 . The method of  claim 2 , further comprising initiating a third therapy based on an acute event detection. 
     
     
         4 . The method of  claim 1 , further comprising initiating a third therapy based on an acute event detection. 
     
     
         5 . The method of  claim 1 , wherein one or more changes in the one or more values associated with the one or more parameters during the titration period do not cause an adverse effect. 
     
     
         6 . The method of  claim 1 , wherein the input obtained from the patient occurs via a magnetic sensor input. 
     
     
         7 . The method of  claim 1 , wherein the one or more processors of the implantable medical device modifies at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on at least one of a patient's age, a patient's level of consciousness, a patient's level of attention, a patient's health status, a patient's gender, a severity of a disorder being treated, a patient's tolerance to one or more adverse events, and a patient's tolerance to pain. 
     
     
         8 . The method of  claim 1 , further comprising: initiating via one or more processors of the implantable medical device a second titration period for a second therapy with a second treatment period, the second therapy including a second electrical stimulation with a second set of parameters; initiating a second modification procedure based on the second set of parameters with a second set of target values; and initiating the second therapy for the second treatment period based on at least one parameter of the second set of parameters being tolerated by the patient or reaching at least one of the second set of target values. 
     
     
         9 . The method of  claim 1 , wherein the one or more processors of the implantable medical device modifies at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on at least one of an emergence of one or more side effects, a level of efficacy, and an event detection. 
     
     
         10 . The method of  claim 1 , wherein the event detection is an acute event detection. 
     
     
         11 . The method of  claim 1 , further comprising acquiring data for at least one of a status report, a historical report, and an alert and transmitting the acquired data or the alert to an external device. 
     
     
         12 . The method of  claim 1 , wherein the one or more processors modifies at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on the patient being asleep. 
     
     
         13 . An implantable medical device comprising:
 one or more processors configured to initiate a titration period for a first therapy with a first treatment period based on an input obtained from a patient, the first therapy including an electrical stimulation with one or more parameters; the one or more processors further configured to initiate a modification procedure of one or more values associated with the one or more parameters during the titration period and to initiate the first therapy for the first treatment period based on one or more parameters being tolerated by the patient or reaching one or more target values.   
     
     
         14 . The implantable medical device of  claim 13 , wherein the modification procedure of the one or more parameters is a gradual function during the titration period or the titration period is adjusted. 
     
     
         15 . The implantable medical device of  claim 13 , wherein the input obtained from the patient occurs via a magnetic sensor input. 
     
     
         16 . The implantable medical device of  claim 15 , wherein the one or more processors of the implantable medical device are configured to modify at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on detecting a sleep state of the patient which includes at least one of a stage one, a stage two, a stage three, a stage four, a REM sleep, a light sleep, and a deep sleep. 
     
     
         17 . The implantable medical device of  claim 13 , wherein the one or more processors of the implantable medical device are configured to modify at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on detecting a sleep state of the patient which includes at least one of a stage one, a stage two, a stage three, a stage four, a REM sleep, a light sleep, and a deep sleep. 
     
     
         18 . The implantable medical device of  claim 13 , wherein the one or more processors of the implantable medical device are configured to modify at least one of the titration period and the modification procedure of one or more values associated with the one or more parameters based on at least one of an emergence of one or more side effects, a level of efficacy, and an event detection. 
     
     
         19 . The implantable medical device of  claim 13 , wherein the one or more processors of the implantable medical device are configured to modify the one or more values on the one or more parameters to a prior tolerable value based on a first state determination which is an emergence of one or more side effects, the one or more processors of the implantable medical device are configured to modify the one or more values on the one or more parameters based on a second state determination which is at least one of a level of efficacy and an event detection. 
     
     
         20 . The implantable medical device of  claim 13 , further including a transceiver configured to transmit at least one of a status report, a historical report, and an alert to an external device.