System and method for multiple site biphasic stimulation to revert ventricular arrhythmias
First Claim
1. A method for biphasic myocardial stimulation, comprising:
- (a) at least two electrodes administering a first stimulation phase having a first phase polarity, a first phase amplitude, a first phase shape, and a first phase duration for preconditioning the myocardium to accept subsequent stimulation;
(b) the at least two electrodes administering a second stimulation phase having a second phase polarity, a second phase amplitude that is larder in absolute value than the first phase amplitude, a second phase shape, and a second phase duration;
(c) sensing for fibrillation; and
(d) repeating steps a), b), and c) if fibrillation is sensed.
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Accused Products
Abstract
An anti-reentry apparatus and method for reverting ventricular arrhythmias. Biphasic stimulation is applied at multiple ventricular sites to revert arrhythmias caused by reentry, particularly multiple random reentry. In the preferred embodiment, the first phase of biphasic stimulation is anodal, and is at a maximum subthreshold amplitude. The anodal phase preconditions the myocardium to accept the second phase (cathodal) such that less electrical energy is required to reach the threshold amplitude to produce depolarization. The anodal phase stimulation may have a shape over time that is square wave, ramped, or a series of short square wave pulses. Multiple electrodes located at multiple ventricular sites may be stimulated simultaneously, or they may be sequentially stimulated over time in a manner mimicking the normal progress pattern of cardiac depolarization. The multiple ventricular electrodes may stimulate from internal or external surfaces. One or both ventricles may receive biphasic stimulation from multiple electrodes. The invention also may be practiced with respect to atria.
101 Citations
22 Claims
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1. A method for biphasic myocardial stimulation, comprising:
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(a) at least two electrodes administering a first stimulation phase having a first phase polarity, a first phase amplitude, a first phase shape, and a first phase duration for preconditioning the myocardium to accept subsequent stimulation; (b) the at least two electrodes administering a second stimulation phase having a second phase polarity, a second phase amplitude that is larder in absolute value than the first phase amplitude, a second phase shape, and a second phase duration; (c) sensing for fibrillation; and (d) repeating steps a), b), and c) if fibrillation is sensed. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method for reverting ventricular arrhythmias with biphasic waveforms, comprising:
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at least two electrodes administering a first stimulation phase having a positive polarity, a subthreshold amplitude, a duration of about one millisecond to about nine milliseconds, and a shape, wherein the shape is selected from the group consisting of square wave pulse, ramped pulse, and series of short duration square wave pulses; and the at least two electrodes administering a second stimulation phase having a negative polarity, an amplitude of about two volts to about twenty volts that is larger in absolute value than the first stimulation chase subthreshold amplitude, and a duration of about 0.2 millisecond to about 1.5 milliseconds.
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Specification