Abstract: An implantable cardioverter defibrillator (ICD) and methods of detection and treatment of dangerous and life-threatening heart rhythms by delivering real-time, customized low-energy pacing pulses to specific anatomy in the heart. The ICD includes a power source, a controller, powered by the power source, including an electronic processor, a memory, and a signal generator. The ICD also includes a lead coupled to the controller and an electrode that is in electrical communication with a His-bundle of a patient's heart. The ICD detects a ventricular arrhythmia of the patient's heart using the controller, and is configured to provide a pulsed defibrillation signal to the electrode to terminate the ventricular arrhythmia.

Abstract: An implantable cardioverter defibrillator (ICD) and methods of detection and treatment of dangerous and life-threatening heart rhythms by delivering real-time, customized low-energy pacing pulses to specific anatomy in the heart. The ICD includes a power source, a controller, powered by the power source, including an electronic processor, a memory, and a signal generator. The ICD also includes a lead coupled to the controller and an electrode that is in electrical communication with a His-bundle of a patient's heart. The ICD detects a ventricular arrhythmia of the patient's heart using the controller, and is configured to provide a pulsed defibrillation signal to the electrode to terminate the ventricular arrhythmia.

Abstract: An apparatus for treating atrial fibrillation or atrial tachycardia comprises means for dynamically steering or selecting two or more current vector paths sequentially or simultaneously for defibrillation to change the transmembrane potential in the left and right atria sufficiently to halt AF or AT. The apparatus is useful to treat AF or AT in patients.

Abstract: An apparatus for treating ventricular fibrillation or ventricular tachycardia comprises means for dynamically steering or selecting two or more current vector paths sequentially or simultaneously for defibrillation so as to change the transmembrane potential in the left and right ventricles sufficiently to halt VF or VT.

Abstract: An apparatus for treating atrial fibrillation or atrial tachycardia comprises means for dynamically steering or selecting two or more current vector paths sequentially or simultaneously for defibrillation to change the transmembrane potential in the left and right atria sufficiently to halt AF or AT. The apparatus is useful to treat AF or AT in patients.

Abstract: An apparatus for treating ventricular fibrillation or ventricular tachycardia comprises means for dynamically steering or selecting two or more current vector paths sequentially or simultaneously for defibrillation so as to change the transmembrane potential in the left and right ventricles sufficiently to halt VF or VT.

Abstract: An implantable cardiac ventricular defibrillation system based upon entirely endovascular placement of a minimal number of electrodes is disclosed. The electrodes are designed to deliver a number of subpulses that are rapidly switched within an overall defibrillation shock envelope. The rapid switching between set pairs of electrodes achieves an overall electric field strength and distribution that is optimized for lowest threshold defibrillation energies and voltages. The defibrillation system also incorporates a system and method for optimally tuning and correlating the parameters of the subpulse delivery to the individualized needs of a human subject. The implantable defibrillation system reduces the energy and voltage levels needed for successful ventricular defibrillation in a clinically feasible manner.