Abstract: An apparatus has advanced amplifier Classes and low pass filter technologies for using software generated ascending or level waveforms that are effective to apply cardiac defibrillation and cardioversion waveforms which significantly reduce damage to the heart muscle or to treat congestive heart failure. The apparatus comprises a waveform energy control system for delivering software generated waveforms comprising one or more differentially driven Class D amplifier sections or differentially driven PWM Class D and Class B or any other class amplifier sections, wherein each Class D amplifier section produces Phase 1 ascending waveforms and has a programmable impedance tracking lowpass filter (LPF) and wherein the Class B or any other class amplifier section delivers hard-switched Phase 2 waveforms.

Abstract: An apparatus has advanced amplifier Classes and low pass filter technologies for using software generated ascending or level waveforms that are effective when applying cardiac defibrillation and cardioversion waveforms which significantly reduce damage to the heart muscle. The apparatus comprises a waveform energy control system for delivering software generated waveforms comprising differentially driven Class D and Class B amplifier sections, wherein the Class D amplifier section produces Phase 1 ascending waveforms and has a programmable lowpass filter (LPF) and wherein the Class B amplifier section delivers hard-switched Phase 2 waveforms.

Abstract: An apparatus has advanced amplifier Classes and low pass filter technologies for using software generated ascending or level waveforms that are effective when applying cardiac defibrillation and cardioversion waveforms which significantly reduce damage to the heart muscle. The apparatus comprises a waveform energy control system for delivering software generated waveforms comprising differentially driven Class D and Class B amplifier sections, wherein the Class D amplifier section produces Phase 1 ascending waveforms and has a programmable lowpass filter (LPF) and wherein the Class B amplifier section delivers hard-switched Phase 2 waveforms.

Abstract: A method and apparatus for treating a cardiac condition in a human or animal patient comprises contacting an area of skin spanning the chest area of the patient with at least two patches or electrode paddles that apply low voltages and currents in a rotational manner to pre-stimulate that area, followed by applying a high voltage shock in rapid succession through the patient's heart through at least two electrode pad patches or paddles, wherein an amplifier-based external defibrillation cardioversion system is used. Also, an external pacing system is employed using ascending ramp or any arbitrary ascending or level waveform for transcutaneous pacing which employ a constant current delivery mode. Treatable conditions include atrial fibrillation (AF), atrial tachycardia (AT), ventricular fibrillation (VF), and ventricular tachycardia (VT).

Abstract: Cardiac defibrillation or cardioversion waveform energy control systems employ transvenous ICDs, subcutaneous SICDs, or pacemakers for treating cardiac conditions. The systems comprise differentially driven amplifier circuit operational modes to control the delivery of pacing, anti-tachycardia pacing, defibrillation, and/or cardioversion electrical shocks, wherein the pacing, anti-tachycardia pacing, and shock waveforms employ constant current, constant voltage, or constant energy. Biphasic arbitrary shock waveforms deliver increasing energy with increasing time as represented by phase 1 ascending ramp, ascending exponential, ascending chopped, ascending stepped, ascending curved, square, or rectilinear and/or any combination of geometric shaped ascending arbitrary waveforms or any BTE waveform.

Abstract: Cardiac defibrillation or cardioversion waveform energy control systems employ transvenous ICDs or subcutaneous SICDs for treating cardiac arrhythmias. The systems comprise differentially driven amplifier circuit operational modes to control the delivery of defibrillation or cardioversion electrical shocks, wherein the shock waveforms are constant current, constant voltage, or constant energy. Biphasic arbitrary shock waveforms deliver increasing and or level energy with increasing time as represented by phase 1 ascending ramp, ascending exponential, ascending chopped, ascending stepped, ascending curved, square, rectilinear or level and or any combination of geometric shaped ascending or level waveforms.

Abstract: A method and apparatus for treating a cardiac condition in a human or animal patient comprises contacting an area of skin spanning the chest area of the patient with at least two patches or electrode paddles that apply low voltages and currents in a rotational manner to pre-stimulate that area, followed by applying a high voltage shock in rapid succession through the patient's heart through at least two electrode pad patches or paddles, wherein an amplifier-based external defibrillation cardioversion system is used. Also, an external pacing system is employed using ascending ramp or any arbitrary ascending or level waveform for transcutaneous pacing which employ a constant current delivery mode. Treatable conditions include atrial fibrillation (AF), atrial tachycardia (AT), ventricular fibrillation (VF), and ventricular tachycardia (VT).

Abstract: Methods, systems and computer program products are provided for reducing a risk of pulseless electrical activity (PEA) include detecting a first post-defibrillation blood flow of a subject and detecting a second post-defibrillation blood flow of the subject after the first post-defibrillation blood flow. If the first post-defibrillation blood flow of the subject is above a first threshold value and the second post-defibrillation blood flow is below a second threshold value, a plurality of electrical pulses that reduces a risk of PEA is delivered.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. For pacing using biventricular synchronization in a patient, a first stimulation signal is applied to a first region of a heart of the patient at a first time and a second stimulation signal applied to a second region of the heart of the patient at a second time to provide biventricular synchronization stimulation of the heart. Cardiac function of the patient associated with application of the first and the second stimulation signals is sensed and a timing relationship of the first stimulation signal to the second stimulation signal is adjusted based on the sensed cardiac function.

Abstract: Methods, systems and computer program products determine and identify a favorable time to deliver cardiac compression to a subject to avoid a vulnerable period of a spontaneous intrinsic cardiac cycle.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein.

Abstract: Methods, systems and computer program products for cardiac pacing are provided. A defibrillation shock is applied to a heart of the patient and a pacing stimulation signal is automatically applied to the heart of the patient subsequent to termination of the delivery of the defibrillation shock. The pacing stimulation may be applied to the heart of the patient within about two seconds of termination of the defibrillation shock. The pacing stimulation signal may be applied to the heart of the patient subsequent to termination of the defibrillation shock irrespective of a characterization of electrical activity detected in the heart. The pacing stimulation may be single and/or paired pacing stimulation.

Abstract: An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned to stimulate Bachmann's bundle, or positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein.

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: Methods, systems and computer program products determine and identify a favorable time to deliver cardiac compression to a subject to avoid a vulnerable period of a spontaneous intrinsic cardiac cycle.

Abstract: Methods, systems and computer program products determine and identify a favorable time to deliver cardiac compression to a subject to avoid a vulnerable period of a spontaneous intrinsic cardiac cycle.

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: Methods, systems and computer program products for combining atrial defibrillation treatment techniques include techniques for reducing the discomfort associated with defibrillation and/or reducing the defibrillation threshold. Techniques include timing the defibrillation shock to reduce discomfort based on a sensed signal, giving the shock relatively early during atrial fibrillation, therapeutic drugs, administering more than one shock in succession, pacing the heart before, after, or during the defibrillation shock or shocks, and placing the shock electrodes in locations that may reduce discomfort.