Method and apparatus for incremental cardioversion or defibrillation
First Claim
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1. A method for cardioverting or defibrillating a patient, comprising the steps of:
- positioning a plurality of electrodes on a plurality of different locations on the patient; and
pulsing different electrodes of said plurality of electrodes over a time period that does not exceed 200 milliseconds using at least three pulses during said time period.
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Abstract
A method is provided for cardioverting or defibrillating a patient'"'"'s heart. A plurality of electrodes is positioned on a plurality of different locations on the patient. Different sets of the plurality of electrodes are pulsed with a plurality of pulses within a maximum time period of 200 milliseconds. By using multiple, relatively low energy shocks to different locations instead of a single large shock, there is significantly less trauma to the patient, and during cardioversion the use of anesthesia may be avoided.
138 Citations
42 Claims
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1. A method for cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; and pulsing different electrodes of said plurality of electrodes over a time period that does not exceed 200 milliseconds using at least three pulses during said time period. - View Dependent Claims (36, 37, 38)
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2. A method of non-invasive cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of non-invasive electrodes on a plurality of different locations on the patient; pulsing different sets of said plurality of non-invasive electrodes with a plurality of pulses within a maximum time period of 200 milliseconds. - View Dependent Claims (39)
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3. Apparatus for cardioverting or defibrillating a patient, which comprises:
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a plurality of electrodes for positioning on a plurality of different locations on the patient including a first set of electrodes comprising at least one of a surface electrode and an esophageal electrode; and
a second set of electrodes;means for pulsing said first set of said plurality of electrodes at a first time period; means for pulsing said second set of said plurality of electrodes at a second time period; at least one electrode of said second set being different from one electrode of said first set; said first time period and said second time period having a total time that does not exceed 200 milliseconds.
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4. A method for cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient including a first set of electrodes comprising at least one of a surface electrode and an esophageal electrode, and a second set of electrodes; pulsing said first set of said plurality of electrodes at a first time period; pulsing said second set of said plurality of electrodes at a second time period; at least one electrode of said second set being different from one electrode of said first set; said first time period and said second time period having a total time that does not exceed 200 milliseconds. - View Dependent Claims (5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; providing a plurality of spaced multiphasic pulses to a first set of said plurality of electrodes at a first time period; providing a plurality of spaced multiphasic pulses to a second set of said plurality of electrodes at a second time period; said plurality of pulses provided to said second set of plurality of electrodes differing from the pulses to said first set of said plurality of electrodes; at least one electrode of said second set being different from an electrode of said second set; said first time period commencing at the patient'"'"'s R-wave with said first time period and said second time period having a total time that does not exceed 200 milliseconds. - View Dependent Claims (14)
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15. Apparatus for non-invasive cardioverting or defibrillating a patient, which comprises:
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a plurality of non-invasive electrodes for positioning on a plurality of different locations on the patient; means for pulsing different sets of said plurality of non-invasive electrodes with a plurality of pulses within a time period that does not exceed 200 milliseconds. - View Dependent Claims (41, 42)
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16. A method for cardioverting atrial fibrillation, which comprises the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; pacing the atrium rapidly; and without discontinuing the pacing, pulsing different sets of said plurality of electrodes with a plurality of pulses within a time period that does not exceed 200 milliseconds, with said pulsing step commencing at the beginning of an R-wave. - View Dependent Claims (17)
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18. A method for cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; and pulsing different electrodes of said plurality of electrodes over a time period during the cycle of the heartbeat which would not cause fibrillation of the heart, using at least three pulses during said time period.
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19. A method of non-invasive cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of non-invasive electrodes on a plurality of different locations on the patient; sensing the ECG signal of the heart; pulsing different sets of said plurality of non-invasive electrodes with a plurality of pulses within a time period during the cycle of the heartbeat which would not cause fibrillation of the ventricle. - View Dependent Claims (20, 21, 22, 23, 24)
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25. A method of cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on plurality of different locations on the patient; sensing the ECG signal of the heart; and pulsing different sets of said plurality of electrodes with a plurality of pulses that are of such strength and geometry as to not fibrillate the ventricle.
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26. A method of cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; sensing the ECG signal of the heart; and pulsing different sets of said plurality of electrodes with a plurality of pulses, with said pulses providing enough energy to capture the atrium but not stimulate the ventricle, whereby cardioversion of the atrium is achieved without stimulating the ventricle. - View Dependent Claims (27, 28)
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29. A method of cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different location on the patient; sensing the ECG signal of the heart; if an arrhythmia to be treated other than ventricular fibrillation is detected, then pulsing different sets of said plurality of electrodes with a plurality of pulses within a time period during the cycle of the heart beat which would not cause fibrillation of the heart; and if ventricular fibrillation is detected, then pulsing said different sets of electrodes with a plurality of pulses without a time period synchronization restriction. - View Dependent Claims (30, 31)
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32. A method of non-invasive cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of non-invasive electrodes on a plurality of different locations on the patient; sensing the ECG signal of the heart; detecting a rhythm to be treated; in response to said detecting step, pulsing different sets of said plurality of non-invasive electrodes with a plurality of pulses within a time period during the cycle of the heartbeat which would not cause fibrillation of the heart. - View Dependent Claims (33)
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34. Apparatus for cardioverting or defibrillating a patient, which comprises:
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a plurality of electrodes for positioning on a plurality of different locations on the patient; means for pulsing a first set of said plurality of electrodes at a first time period; means for pulsing a second set of said plurality of electrodes at a second time period; means for pulsing a third set of said plurality of electrodes at a third time period; at least one electrode of each set being different from an electrode of the other sets; said first time period and said second time period having a total time that does not exceed 200 milliseconds.
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35. A method for cardioverting or defibrillating a patient, comprising the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; pulsing a first set of said plurality of electrodes at a first time period; pulsing a second set of said plurality of electrodes at a second time period; pulsing a third set of said plurality of electrodes at a third time period; at least one electrode of each set being different from an electrode of the other sets; said first, second and third time periods having a total time that does not exceed 200 milliseconds.
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40. A method for cardioverting atrial fibrillation, which comprises the steps of:
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positioning a plurality of electrodes on a plurality of different locations on the patient; stimulating the atrium rapidly; and without discontinuing the stimulating, pulsing different sets of said plurality of electrodes with a plurality of pulses within a time period that does not exceed 200 milliseconds, with said pulsing step commencing at the beginning of an R-wave.
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Specification