Method and apparatus for cardiac defibrillation

Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems

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A61N 136

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054257484

ABSTRACT:
An implantable defibrillator and method for its use are disclosed. Amplified heart signals are fed back to a fibrillating heart to cause defibrillation by creating consistent enhancement and/or interference between the natural electrical signals in the heart and the coherent defibrillation signal. A unipolar endocardial sensing lead positioned in the right ventricular apex provides sensed electrical signals from the heart to a differential amplifier located in an implantable defibrillator. The amplified signal is provided to a sample and hold circuit which is disconnected from the amplifier by a switch during delivery of a defibrillation signal. The amplified heart signal from the sample and hold circuit is conditioned in a linear or non-linear manner and then further amplified by an isolation amplifier. The signal from the isolation amplifier is applied to the heart for periods of on the order of hundreds to thousands of milliseconds. A detector senses the amplitude of the signal at a point between the differential amplifier and the isolation amplifier and discontinues the defibrillation pulses upon detection of reduced cardiac activity for a predetermined period of time.

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"Ventricular Defibrillation Using Biphasic Waveforms: the Importance of Phasic Duration" (Tang, et al) JACC vol. 13, No. 1, pp. 207-214, Jan. 1989.

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