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Neurostimulation with the SynergyT System

Backed by two decades of Medtronic's experience in implantable technologies, the SynergyT system was developed to address the limitations associated with single-lead neurostimulation systems and to meet the need for greater flexibility in managing different types of pain and
laterality of pain.

The SynergyT neurostimulation system is the first totally implantable dual channel system available for the management of chronic, intractable pain. Furthermore, SynergyT is Medtronic's most powerful neurostimulation system, providing greater pain relief for a longer duration and greater convenience with less frequent battery replacement.

Neurostimulation with SynergyT increases the chance of successfully managing more types
of pain amongst a wider range of patients:

The dual-stimulation capability of SynergyT confers greater flexibility, on either one or two leads, to generate paraesthesia and therefore to provide more effective pain relief. If one
lead is not sufficient to cover pain adequately, a second lead can be added at a later date
The use of dual channels, which means that up to 8 electrode options can be programmed
to two independent patterns of stimulation, enables physicians to cover changing pain patterns over time

Programming of neurostimulation devices

The goal of programming
The primary goal of programming is to superimpose the stimulation
or paraesthesia pattern over the patient's pain pattern and to establish the correct stimulation waveform (amplitude, pulse width, rate, etc).
A secondary goal of programming is to prolong battery life through stimulation options. All programming of Medtronic neurostimulation devices is carried out with the N'VisionT programmer.

Programming parameters
Each patient requires their own unique stimulation pattern to help control their pain. This stimulation pattern may need to be adapted
over time, especially during the first few weeks following implantation, when the lead may change position slightly following abrupt movements. Therefore, adjustments in stimulation may be needed
to adequately manage pain.

Stimulation waveform parameters
There are four basic elements or parameters in neurostimulation applications which can be adjusted to meet individual pain control needs.

Therapeutic parameters of neurostimulation

Amplitude	A measure of the intensity or strength of the stimulation. It is experienced by the patient as the strength of the paraesthesia.Amplitude is measured in volts (V). It can be set from 0 to 10.5 V, depending on the patient's needs
Pulse width	A measure in microseconds (µs) of the duration of a pulse. In general, the wider the pulse width, the larger the tissue area being stimulated, and the stronger the sensation of paraesthesia. For neurostimulation, the pulse width is commonly set at 180 µs
Rate	The number of times per second that a pulse is delivered. It is measured in pulses-per-second (pps) or Hertz (Hz). The rate is typically set between 30 to 80 pps
Electrode	This includes bipolar or unipolar (Itrel system only) stimulation selection. All four electrodes of each lead can be selected to be active with either negative or positive polarity provided that at least one positive pole and at least one negative pole are selected

Pain Management