Abstract: Methods and apparatus are provided for generating multiphasic charge-balanced cardioversion and defibrillation shocks to apply to a patient's heart to terminate episodes of arrhythmia such as tachycardia and fibrillation. The time-integrated positive shock phase current equals the time-integrated negative shock phase current. The use of charge-balanced shocks has been determined to significantly reduce the effects of post shock block that result when conventional shocks are applied to the heart.

Abstract: A system and method for a pacemaker are provided, for using cardiac wall motion sensor signals to provide hemodynamically optimal pacing therapy to patient at rest, and for providing rate-responsive pacing therapy. The cardiac wall motion sensor signals are provided by an implantable lead that incorporates an accelerometer for measuring cardiac mechanical activity. The cardiac wall motion sensor signals are processed to derive cardiac wall velocity signals and cardiac wall displacement signals. The derived signals are further processed to derive physiologic parameters indicative of cardiac performance, including stroke volume, contractility, pre-ejection period, and ejection time. The physiological parameters, in turn, are used by the pacemaker to provide hemodynamically optimal pacing therapy at rest, and rate-responsive pacing therapy.

Abstract: A processing system and method are provided for deriving an improved hemodynamic indicator from cardiac wall acceleration signals. The cardiac wall acceleration signals are provided by a cardiac wall motion sensor that responds to cardiac mechanical activity. The cardiac wall acceleration signals are integrated over time to derive cardiac wall velocity signals, which are further integrated over time to derive cardiac wall displacement signals. The cardiac wall displacement signals correlate to known hemodynamic indicators, and are shown to be strongly suggestive of hemodynamic performance. An implantable cardiac stimulating device which uses cardiac wall displacement signals to detect and discriminate cardiac arrhythmias is also provided.

Abstract: A patch electrode including a generally oval-shaped metallic mesh affixed to a polymer insulation backing and an insulation frame, and further including a plurality of specially designed lattices which divide the metallic mesh into a plurality of windows or apertures. The windows effectively act as smaller electrodes distributing the higher current densities inward from each of their own individual edges.