Abstract: An implantable cardioverter defibrillator (ICD) system includes an internal electrode placed in the right ventricle of the heart, and a flexible array (that includes a plurality of electrodes) placed over a significant portion of the heart. Defibrillation shocks are applied between the internal electrode in the ventricle and the electrodes in the flexible array. Because the electrodes in the flexible array surround a significant portion of the heart, the array functions as a quasi-Faraday cage and is thus capable of confining a significant portion of the defibrillation shock field to the heart itself. As a result, defibrillation shocks are less likely to activate extracardiac muscle(s) and/or nerve tissue(s) within the surrounding chest. Application of the shocks is thus less painful to the patient.

Abstract: There is disclosed a surgical lead comprising two percutaneous lead bodies bonded together. The inventive lead body results in the equivalent of a surgical lead body with columns of electrodes either adjacent to or offset from each other. A bridge of urethane material is used to bond together the percutaneous lead bodies and still provide suitable flexibility of the lead. The surface of the electrodes may be coated, in part, with a suitable non-conductive coating to effectively direct the electrical stimulation signals toward the targeted stimulation area. Significantly, the resulting lead is sized to fit within a needle having a similar cross-section, thereby permitting the percutaneous implantation of the inventive lead.

Abstract: A method for regulating the heart rate of a patient comprises inserting into a blood vessel of the patient a catheter having an electrode assembly at its distal end. The electrode assembly comprises a generally circular main region that is generally transverse to the axis of the catheter and on which is mounted at least one electrode. The catheter is directed to an intravascular location wherein the at least one electrode on the electrode assembly is adjacent a selected cardiac sympathetic or parasympathetic nerve. The at least one electrode is stabilized at the intravascular location. A stimulus is delivered through the at least one electrode, the stimulus being selected to stimulate the adjacent sympathetic or parasympathetic nerve to thereby cause a regulation of the patient's heart rate.

Abstract: An electrokinetic system for delivering a substance into tissue includes an alternating current source of a predetermined frequency. A first electrode is coupled to a first terminal of the alternating current source and a second electrode is coupled to a second terminal of the alternating current source. A rectifying circuit is coupled between the first electrode and the first terminal of the alternating current source. One of the first and second electrodes is adapted for electrical contact with a substance-delivery site. A current rectified by the rectifying circuit flows in a current path between the first and second electrodes when the one of the first and second electrodes is in electrical contact with the substance-delivery site to effect delivery of the substance into the tissue.

Abstract: A sensor for biopotential measurements is designed to detect low voltage electrical signals on a subject's skin surface. A plurality of soft elastomeric bristles are arranged about the surface of the skin. Various bristles contain a wick, made of polyolefin, polyester or nylon, extending along its center axis with one end protruding from the bristle and another end in contact with a fluid reservoir. The wick is saturated with an electrically conductive liquid, such as a salt solution. The solution may contain a surfactant. The rheological properties of the electrically conductive liquid are optimized for predictable flow through the wick onto the skin surface. An electrode is positioned in the vicinity of the wick and the reservoir. Alternatively, a sensor comprises a plurality of hollow, soft elastomeric bristles filled with a hydrogel. An electrically conductive cap provides the electrical contact between the hydrogel and the electrical circuit.

Abstract: A method for in vivo electrotherapy, or electroporation-mediated therapy, using a needle array apparatus is provided. Treatment of tumors with a combination of electroporation using the apparatus of the invention, and a chemotherapeutic agent, caused regression of tumors in vivo.

Abstract: A therapeutic device system provides therapeutic application of energy to a living body. The energy is applied by the action of photon-emitting diodes, and photon emitting diodes in combination with transcutaneous electrical stimulators. A power grid is adapted to provide electrical current for operation of the energy sources. A shapable housing contains the energy sources and the power grid. The shapable housing is selectively moldable with memory retention to retain a shape configuration, and may be cast or adapted conformably as a custom or generically sized device over a treatment area and placed on the living body. Program instructions provide for implementation of a plurality of therapeutic modalities.

Abstract: An apparatus and method for relative movement of electrodes in a medical lead are provided. The apparatus includes first and second electrode nodes and a wire connecting the electrode nodes. The wire includes a deformable sigma segment that allows movement of one or both of the first and second electrode nodes relative to each other. The method includes placing the medical lead adjacent tissue. The method further includes moving one of the electrode nodes relative to the other of the electrode nodes.

Abstract: An electrical stimulation device method provides for exact repeatable positioning of stimulation pads onto a body part. The device includes a flexible member for contacting a body part and hook/loop members for tightly supporting the flexible member against the body part. At least one electrical bus is provided which may include a connector for enabling connection of the bus to an electrical lead wire and an electrical contact disposed on the inside of the flexible member. A conductive pad is provided which has dimensions substantially smaller than the dimensions of the flexible member and includes a cover adhesive layer for removably adhering the conductive pad to the flexible member inside with a first side of the cover layer covering the bus contact and an electrical communication therewith. A current controlling media is adhered to a second side of the cover layer and a base layer disposed on the current controlling media is provided for removably adhering the conductive pad to the body part.

Abstract: A method for in vivo electrotherapy, or electroporation-mediated therapy, using a needle array apparatus is provided. Treatment of tumors with a combination of electroporation using the apparatus of the invention, and a chemotherapeutic agent, caused regression of tumors in vivo.

Abstract: A device for administrating electro-muscle stimulation (EMS) includes a flexible covering having a plurality of spaced apart electrodes (22). In a preferred embodiment the flexible covering is shaped like a belt (24) and is designed to encircle and be connected around a portion of a patient's body (506). The belt is fabricated from an elastic material so that the electrodes are pressed against the skin of the patient to promote better electrical conduction. The electrodes are selectively positionable to different locations on the belt, so they may be placed directly over a selected muscle or muscle group. Each electrode has its own individual control (32) for adjusting the level of the electrical stimulation signal, so that (1) different muscles can receive different levels of stimulation, and (2) the level of stimulation may be changed during the course of treatment. A master adjustment control (504) is used to adjust the stimulation signal level applied to all the electrodes.

Abstract: A blood circulation stimulator is constructed to include a bottom cover shell, a top cover shell covered on the bottom cover shell and holding a battery set, a contact circuit board mounted inside the bottom cover shell to hold a plurality of spring-supported magnetic rod members and a plurality of electric current discharge rod members, and an electric current generator mounted in the top cover shell and controlled to output a low voltage electric current to the contact circuit board and then the electric current discharge rod members for stimulating the blood circulation of a person, the spring-supported magnetic rod members and the electric current discharge rod members each having a bottom end extending out of the bottom cover shell through a respective through hole on the bottom cover shell.

Abstract: An electrode structure containing plural electrode elements each comprising an electrode and an electrolyte layer laminated thereon, the electrode of each electrode element being connected to a power supply and the electrolyte layer to be in contact with the skin, wherein the plural electrode elements are insulated from each other and the electrode of each element is electrically connected to a resistor that limits the current flowing through this electrode, the resistor having a resistance that is ⅕-5 times the resistance of the skin. The present invention provides an electrode structure capable of making the density of the current flowing to the skin constant, irrespective of the electrification method, and capable of reducing irritation due to the electrification.

Abstract: An electro-stimulation apparatus comprises an electrode system for measuring local electrical impedance. The electrode system includes a multitude of electrode pads and a counter electrode held at a reference voltage. The electrode pads and the counter electrode are assembled in an electrode unit. A particular embodiment of the electro-stimulation apparatus comprises an electronic circuit including a source group of electrode pads and a sink group of electrode pads and a source conductor for applying a first electrical quantity to electrode pads of the source group. The electronic circuit also includes a sink conductor for receiving a second electrical quantity from electrode pads of the sink group. Switching elements couple individual electrode pads of the source group to the source conductor. Other switching elements couple individual electrode pads of the sink group to the sink conductor.

Abstract: The present invention provides a method of controlling cardiac fibrillation, tachycardia, or cardiac arrhythmia by the use of an electrophysiology catheter having a tip section that contains at least one stimulating electrode, the electrode being stably placed at a selected intravascular location. The electrode is connected to a stimulating means, and stimulation is applied across the wall of the vessel, transvascularly, to a sympathetic or parasympathetic nerve that innervates the heart at a strength sufficient to depolarize the nerve and effect the control of the heart.

Abstract: Electrodes and electrode array apparatus and systems for in vivo delivery of electrical waveforms rendering therapeutic benefit to the patient by utilizing an electrode array having at least three electrodes disposed so as to form an isosceles triangle in a plane intersecting the electrodes and electrical signal generating means operatively connected to the electrodes for delivering electrical waveforms to said electrodes and generating electroporation-inducing electrical fields between the electrodes

Abstract: An artificial retina device and a method for stimulating and modulating its function is disclosed. The artificial retina device is comprised of plural multi-phasic microphotodiode subunits. In persons suffering from blindness due to outer retinal layer damage, a plurality of such devices, when surgically implanted into the subretinal space, may allow useful formed artificial vision to develop. One device, called a MMRI-4, transduces light into electric currents to stimulate the retina. The four microphotodiode subunits of the MMRI-4 are oriented so that each flattened sides of the MMRI-4 has two subunits in a PiN configuration and two subunits in a NiP configuration. Filter layers disposed on the PiN configuration will allow visible light to induce a PiN current, and filter layers disposed on the NiP configuration will allow infrared light to induce a NiP current.

Abstract: An electrode template apparatus, includes a three dimensional support member having opposite surfaces, a plurality of bores extending through the support member and through the opposite surfaces, a plurality of conductors on the member separately connected to the plurality of bores, a plurality of needle electrodes selectively extendable through the plurality of bores and into tissue to be electroporated so that each electrode is comcected to at least one conductor for connecting the electrodes to a power supply.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: A method is provided for the introduction of an agent to a neoplastic cell for electroporating the cell, including contacting the cell with an electrode template apparatus. The electrode template apparatus is utilized to apply an electric field to the cell in order to introduce the agent into the cell. A method is also provided for the introduction of an agent to a tissue for electroporating a cell in the tissue, including contacting the tissue with an electrode template apparatus. The tissue is contacted with the agent and a pulse of high amplitude electric signals is applied to the cell utilizing the apparatus, for electroporation of the cell with the agent.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is proved with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by he body of the pacemaker.

Abstract: A transcutaneous medical electrode includes a highly conductive grid, having a plurality of arrays of electrical conductors, for controlling current distribution of directed electrical pulses. Electrical connectors are provided for establishing electrical communication with the conductive grid for enabling selective electrification of the electrical conductors in each array. The conductive grid is supported by a moderately conductive sheet, or film, and a conductive adhesive is provided for removably coupling the sheet or film and the conductive grid to a user's body.

Abstract: The invention concerns a microelectrode arrangement for leaking, with local resolution, electrical cell potentials, or for electrical stimulation of networks of biological cells such as for example cell cultures, tissue slices "in vitro" or biological tissue "in vivo". In order to attain high local resolution and high temporal resolution, the invention suggests that, as microelectrodes (M.sub.1 to M.sub.n), in each instance a contacting electrode (K.sub.1 to K.sub.n) be placed above a pad electrode (A.sub.1 to A.sub.n) onto a substrate (S); with light-sensitive elements, preferably in the shape of a continuous layer (P) arranged between the said contacting electrodes and the pad electrodes. By illuminating the light-sensitive layer (P) in the region of individual microelectrodes (M.sub.1 to M.sub.n), these microelectrodes are selected. Selection is preferably by the transmitted-light process through the substrate (S). In this case, substrate (S) and pad electrodes (A.sub.1 to A.sub.n) must be translucent.

Abstract: A catheter system comprising a delivery catheter and an inner catheter, wherein the inner catheter is deployable and has a plurality of electrodes on the lattices of a trellis fixture. During a deployed state, the trellis fixture is fully extended to have a series of electrodes on a two-dimensional plane for mapping and/or ablation purposes.

Abstract: An electrode template apparatus, comprises a three dimensional support member having opposite surfaces, a plurality of bores extending through the support member and through the opposite surfaces, a plurality of conductors on the member separately connected to the plurality of bores, a plurality of electrodes selectively insertable in the plurality of bores so that each electrode is connected to at least one conductor for connecting the electrodes to a power supply.

Abstract: A flexible cuff for wrapping around a part of a limb, that is comprised of multiple biosensing patch units of a required size and shape to fit the body contour for applying to an area of skin. The cuff has an array of flexible porous (polymer) electrodes held at constant potential with alternating polarities. A network of supply tubes connected to an external liquid reservoir provides a slow supply of medicated fluid to each electrode. A pump/titration regulator is in communication with the transdermal electrode to regulate permeant flow to the skin. An electric and an electromagnetic field applied through the cuff then causes the drug to be rapidly absorbed throughout the skin. The electrodes within the cuff, or the applicator pads which it is comprised of, can be additionally used for applying electromagnetic, Transcutaneous Nerve Stimulation, and for Electrical Muscle Stimulation.

Abstract: A portable, self-powered device for acupuncture-type percutaneous treatment comprising a casing having on its bottom a plurality of metallic contact blocks, each contact block constituting the terminal of a pulse generator mounted in this casing, means provided for removably attaching the casing on a portion of a patient's body, and an electronic program comprising seven therapeutic functions for connecting at least two contact blocks to the pulse generator, the connections with the contact blocks being chosen in accordance with the condition to be treated. An application for the device is in particular the treatment of obesity.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: A bioelectric interface is disclosed which provides three Einthoven triangle equivalent lead forming electrodes positioned on a subject's chest so as to provide a Wilson common terminal voltage essentially equivalent to that provided by an Einthoven triangle formed using leads positioned conventionally on a subject's limbs. Wilson common terminal forming resistors can be of fixed values or variable to allow adjustment of a produced Wilson common terminal voltage. Additional precordial electrodes are also typiclaly present. Electrodes can consist of single elements or groups of electrode elements, and are present in locational regions of the bioelectric interface which allow a single size system to fit to patients with various sized bodies. The electrodes can be of various physical shapes to allow not only direct signal measurement, but also to allow monitoring of high frequency content of signals and to allow enhanced resolution of a region from which measured signals originate.

Abstract: Disclosed herein are several unique configurations of electrodes for stimulation of brain tissue. Specifically, a configuration of electrodes is disclosed that has at least one electrode on the brain's surface and at least one additional electrode located deep within the tissue of the brain. It is envisioned that all such electrodes would be located in close proximity to a particular region of the brain such as an epileptic focus. It is further envisioned that several brain surface electrodes would be used in conjunction with several deep brain electrodes. Specifically, it is envisioned that all surface electrodes would be electrically joined together and all deep electrodes would be electrically joined together.

Abstract: A low-frequency electrotherapeutic device can overcome problems ascribable to tolerance in neural response and problems ascribable to accumulation of electric charge in a living body, thereby affording a comfortable massaging effect. Each electrode can be designated as a different electrode or as an indifferent electrode by a controller. Electrodes do not assume a fixed paired structure, and the path of stimulating electric current is changed at predetermined intervals by scanning electrodes serving as different electrodes. The path of an electric current flowing on the skin of a living body can be changed in various ways, the number of which corresponds to the number of paths connecting the electrodes. Consequently, it becomes possible to freely select a desired electric current path or a desired combination of electrodes in accordance with a program stored in a control section (CPU) incorporated in the controller. Also, it becomes possible to automatically change the combination at predetermined intervals.

Abstract: A transcutaneous medical electrode includes a highly conductive grid, having a plurality of arrays of electrical conductors, for controlling current distribution of directed electrical pulses. Electrical connectors are provided for establishing electrical communication with the conductive grid for enabling selective electrification of the electrical conductors in each array. The conductive grid is supported by a moderately conductive sheet, or film, and a conductive adhesive is provided for removably coupling the sheet or film and the conductive grid to a user's body.

Abstract: An artificial retina device and a method for stimulating and modulating its function is disclosed. The artificial retina device is comprised of plural multi-phasic microphotodiode subunits. In persons suffering from blindness due to outer retinal layer damage, a plurality of such devices, when surgically implanted into the subretinal space, may allow useful formed artificial vision to develop. One device, called a MMRI-4, transduces light into electric currents to stimulate the retina. The four microphotodiode subunits of the MMRI-4 are oriented so that each flattened sides of the MMRI-4 has two subunits in a PiN configuration and two subunits in a NiP configuration. By projecting real or computer controlled visible light images, and computer controlled infrared light images or illumination, simultaneously or in rapid alternation onto the MMRI-4s, the nature of induced retinal images may be modulated and improved.

Abstract: The electric field steering assembly is used to control the size and/or location of, and/or steer the position of, an electric field in a living creature. The assembly comprises a pulse generator or stimulator, at least one implanted lead coupled to the stimulator and having, at a distal end thereof, at least three spaced apart electrodes, and electrical circuitry for adjusting the current and/or voltage at each electrode.

Abstract: Electrodes and electrode array apparatus and systems for in vivo delivery of electrical waveforms rendering therapeutic benefit to the patient by utilizing an electrode array having at least three individually addressable electrodes disposed so as to form a triangle in a plane intersecting the electrodes and an electrical signal generating device operatively connected to the electrodes for delivering electrical waveforms to said electrodes and generating electroporation-inducing electrical fields between the electrodes.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is proved with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by he body of the pacemaker.

Abstract: An input command controller (A) provides logic function selection signals and proportional signals. The signals are generated by movement of a ball member (12) and socket member (14) relative to two orthogonal axes. When the joystick is implanted, a transmitter (50) transmits the signals to a patient carried unit (B). The patient carried unit includes an amplitude modulation algorithm such as a look-up table (124), a pulse width modulation algorithm (132), and an interpulse interval modulation algorithm (128). The algorithms derive corresponding stimulus pulse train parameters from the proportional signal which parameters are transmitted to an implanted unit (D). The implanted unit has a power supply (302) that is powered by the carrier frequency of the transmitted signal and stimulation pulse train parameter decoders (314, 316, 318). An output unit (320) assembles pulse trains with the decoded parameters for application to implanted electrodes (E).

Abstract: A method for controlling changes in stimulation of every sort and kind including electrical stimulation, utilizes a three-dimensional 1/f fluctuation. The method is a change control method for controlling changes in stimulation to an object using a three-dimensional 1/f fluctuation and includes the steps of causing changes based upon 1/f fluctuation periods in the X-Z plane of a X-Y-Z space, causing changes based upon 1/f fluctuation periods in the X-Y plane of the space, superposing the caused changes of the previous steps, and applying the superposed caused changes to the object. This makes it possible to realize a low-frequency device free of problems attributable to the tolerance in neural response. A recording medium used to store the change control method, and a change control device using a three-dimensional 1/f fluctuation are also disclosed. Changes based on 1/f fluctuation periods in the X-Z plane and changes based on 1/f fluctuation periods in the X-Y plane are superposed on each other.

Abstract: A relatively high-frequency electric current is generated, to be applied to the human body by means of one active and one passive electrode. It is distinct because, in order to raise the temperature of the human body in a local sense to 45.degree.-46.degree. C., it comprises a return electrode consisting of a metal plate and an active electrode, likewise metal, of smaller dimensions than the return electrode. The difference in dimensions between the two electrodes, placed facing on either side of the body region to be treated, brings about an increase in the impedances which, combined with the power frequency amplifier generator, brings about the required rise in temperature for treatment at local level.

Abstract: An adapter for connecting combination electrodes to a defibrillator/monitor/pacer. The adapter isolates the pacer from the defibrillator when a defibrillation pulse is applied over the combination electrodes. In a first embodiment of the adapter, the pacer is conductively connected to the combination electrodes only when the pacer's power supply is turned on. In a second embodiment of the adapter, the pacer is normally connected to the combination electrodes, but is disconnected when the defibrillator/monitor/pacer is analyzing a patient's ECG or when the defibrillator is charging to enable it to deliver a defibrillation pulse. Also provided in the adapter is a contact assembly for connecting the adapter to defibrillation paddles from the defibrillator.

Abstract: Electrical stimulation for the treatment of neuro-muscular disorders, in particular incontinence. A portable electrical stimulation apparatus for treatment of incontinence, comprising one or more electrodes (302) for applying one or more electrical stimulation signals to a patient's body, a signal generator for generating the electrical stimulation signal(s), one or more conductive leads for connecting the signal generator to the electrode(s), to deliver the electrical stimulation signal to the electrode(s); and a power supply, characterized in that the apparatus includes an instruction storage or a programming device for imparting a set of instructions to the signal generator, the signal generator being responsive to the instruction storage or programming device so that the generated signal adopts signal waveform characteristics selected in accordance with said set of instructions.

Abstract: Heart rhythm is stabilized within the heart's free running cycle by detecting arrhythmias in a mammalian subject, and then electronically stimulating the subject's vagus and cardiac sympathetic nerves. More specifically, vagus efferents are stimulated to directly cause heart rate to slow down, while cardiac sympathetic nerve efferents are stimulated to cause the heart rate to quicken. Simultaneously, afferents from vagus and/or cardiac sympathetic nerves induce the brain to employ the brain's natural mechanisms of heart rhythm control. Such nerve stimulation works in harmony with the body's natural mechanisms of heart rhythm control.

Abstract: A portable or implantable gastric pacemaker includes multiple electrodes that are positionable on the inner or outer surface of an organ in the gastro-intestinal tract and which are individually programmed to deliver a phased electrical stimulation to pace peristaltic movement of material through the GI tract. The pacemaker will accommodate variations in pulse amplitudes, pulse durations, pulse periods, and relative pulse phasing among the electrodes. Computer control can be used to adjust and vary all stimulation parameters delivered by the electrodes to achieve effective treatment and re-training of an organ for natural pacing. The pacemaker can be programmed with parameters to enhance or accelerate peristaltic movement through the gastric tract or to attenuate the peristaltic movement to treat such conditions eating disorders or diarrhea.

Abstract: A bioelectric interface is disclosed which provides a plurality of electrodes affixed to an adhesive sheet which demonstrates electrode isolating anisotropic electrical specific impedance properties simultaneous with isotropic pliability and adhesion mechanical properties. The bioelectric interface can be configured to provide electrodes positioned for use in, for instance, twelve lead (ECG) systems as well as in any other configuration. Groups of electrodes can be present in certain locational regions to allow single sized systems to fit to patients with various sized bodies. The electrodes can be of various physical shapes to allow not only direct signal measurement, but also to allow monitoring of high frequency content of signals and to allow enhanced resolution of a region from which measured signals originate. When present, extra electrodes in a group thereof can be used for purposes, such as cardiac pacing.

Abstract: A pacemaker system adapted to deliver pacing pulses in the presence of fibrillation. The pacing pulses are delivered via large surface area electrodes of the type normally used to accomplish defibrillation or cardioversion using high voltage pulses. An extended pulse train is delivered in order to gradually entrain greater portions of heart tissue, until a sufficient percentage of tissue is entrained to interrupt fibrillation. The invention is believed most applicable to treatment of atrial fibrillation.

Abstract: Systems and methods sense electrical events about a selected annulus region of the heart to identify the location of an accessory pathway. The systems and methods establish a contact site between heart tissue along the selected annulus and a multi-electrode array having a generally circular shape that conforms to the circumferential geometry of the selected annulus region. The systems and methods maintain the site of contact between the electrode array and heart tissue, while conveying signals representing electrical events sensed by bipolar pairs of the electrodes in the selected annulus region. The systems and methods display the signals as graphic information that represents the time differences between the atrial and ventricular electrogram complexes sensed by bipolar pairs of the electrodes on the selected annulus region. The bipolar pair of electrodes displaying the least time separation between the atrial and ventricular complexes identifies the region of the accessory pathway.

Abstract: An electrotherapy device is capable of a person independently, simultaneously locating the most appropriate and effective treatment sites before administering electrotherapy and massage for acute and chronic pain. A stiff elongated support member has an electrical conductor/physical stimulator attached to an arcuate distal end. The electrical conductor/physical stimulator is attached to an electric signal generator for providing electrotherapy signals while a patient simultaneously massages a point on the patient's body with the electrical conductor/physical stimulator. The device also provides the user the ability to locate the most appropriate treatment sites for providing relief of their symptoms.

Abstract: A heart pacemaker which is arranged to stimulate the apical area of the heart. Stimulation of this area provides synchronous mechanical contraction of the left and right ventricles and overcomes the problem of pacemaker induced left bundle branch block type conduction disturbance. The pacemaker has a base surface which conforms to the apical area of the heart and mounts a plurality of epicardial stimulating electrodes. Selection of electrodes can be made to provide the most clinically appropriate stimulation. An opposite side of the pacemaker is arranged to contact the diaphragm and is provided with sensing electrodes to sense activity of the diaphragm and adjust pacing of the heart in accordance with changes in physical activity of the patient. The electrodes used are preferably of capacitive construction, having first and second capacitive plates either side of a dielectric formed by the body of the pacemaker.

Abstract: Multi-phase RF ablation employing a two-dimensional or three-dimensional electrode array produces a multitude of currents paths on the surface of the ablation zone. This results in a uniform lesion with a size defined by the span of the electrode array. An orthogonal electrode catheter array suitable for cardiac ablation is used in conjunction with a two-phase RF power source to produce uniform square-shaped lesions of size 1.2 cm.sup.2. Lesions of larger size are created by successive adjacent placement of the square-shaped lesions. A temperature sensor at the electrode tip allows monitoring of ablation temperature and regulation of thereof to minimize the electrode tips from being fouled by coagulum. In another embodiment, an external auxiliary electrode is used in combination with the catheter electrodes. This also produces lesions of greater depth. In yet another embodiment, ablation is performed with a sequence of elementary electrode-electrical configurations.

Abstract: Improved apparatus for the iontophoretic transdermal delivery of medication across the membrane formed by the body's skin is provided so the medication can be absorbed by the adjacent tissues and blood vessels. The improved apparatus is not reuseable and can be adapted for large dermal area application or for smaller sized area application, based on the specific electrode employed.