Abstract: An atrial defibrillation system includes an implantable atrial defibrillator including an atrial fibrillation detector and an atrial cardiovertor, and an external communication device dimensioned to be hand-held and including an RF transmitter for transmitting a command signal to the implanted defibrillator. The implantable defibrillator includes a receiver for receiving the command signal, activation means responsive to receipt of the command signal for activating the atrial fibrillation detector and the atrial cardiovertor if the atrial fibrillation detector detects atrial fibrillation, and an RF transmitter for transmitting an acknowledgment signal to the external communication device responsive to the receiver receiving the command signal. The external communication device further includes a receiver for receiving the acknowledgment signal and an indicator for providing a perceptible indication responsive to receipt of the acknowledgment signal.

Abstract: An implantable atrial defibrillator provides adaptive output voltage control. An atrial cardiovertor is responsive to an atrial fibrillation detector for applying a cardioverting voltage having a magnitude to the atria of a heart when the atria are in need of cardioversion. A memory stores data associated with each such voltage application. A computation stage computes from the stored data a percentage of success which is compared to lower and upper limits. The output voltage is incremented or decrement based upon the comparison. The output voltage may further be maintained within a fixed preselected voltage range.

Abstract: A pulse generator for use in a defibrillator provides cardioverting electrical energy to a heart through at least one lead having a pair of electrodes associated with the heart. Electrical energy is applied to the heart with a biphasic waveform having a first cardioverting phase and a second cardioverting phase. A crosspoint switch selectively couples a storage capacitor to the lead means. A master switch decouples the crosspoint switch from the storage capacitor while the crosspoint switch connections are changed between the first cardioverting phase and the second cardioverting phase. A control circuit provides independent control of the duration of both the first and second cardioverting phases.

Abstract: A method and apparatus for applying an asymmetric biphasic exponential waveform countershock to the heart useful in an implantable cardioverter or defibrillator, wherein the second phase has a start amplitude of substantially one half that of the first phase, and wherein the polarity of a capacitor discharging through a current path including the heart is reversed. A voltage reversing circuit may include a voltage shifter which shifts voltage associated with switching elements in the circuit to reduce voltage stresses in the switching elements.