Abstract Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
A process for applying defibrillation pulses to a human heart, including the steps of: implanting a first compliant electrode in a patient, subcutaneously, proximate the pleural cavity and outside of the rib cage, and on a first side of a thoracic region; implanting a second compliant electrode subcutaneously, proximate the pleural cavity and outside of the rib cage and on a second side of the thoracic region opposite the first side, with at least a portion of the heart between the first electrode and the second electrode; implanting a defibrillation pulse generator; and electrically coupling the first and second electrodes to a defibrillation pulse generator and providing defibrillation pulses from the pulse generator, to the first electrode and from the first electrode to the second electrode via body tissue.
Claim 2
Dependent Claim
129 words
A process for applying defibrillation pulses to a human heart, including the steps of: implanting a first compliant electrode in a patient, subcutaneously, proximate the pleural cavity and outside of the rib cage, and on a first side of a thoracic region; implanting a second compliant electrode subcutaneously, proximate the pleural cavity and outside of the rib cage and on a second side of the thoracic region opposite the first side, with at least a portion of the heart between the first electrode and the second electrode; implanting a defibrillation pulse generator; and electrically coupling the first and second electrodes to a defibrillation pulse generator and providing defibrillation pulses from the pulse generator, to the first electrode and from the first electrode to the second electrode via body tissue.
Claim 3
Dependent Claim
53 words
The process of claim 1 wherein: said step of implanting the first electrode comprises locating the first electrode at a position anterior and to the left of heart, and the step of implanting the second electrode comprises locating the second electrode at a position to the right of and posterior of the heart.
Claim 4
Dependent Claim
32 words
The process of claim 2 further including the step of: implanting the defibrillation pulse generator at a location anterior of and to the left of the heart, and below the first electrode.