Current waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator

Abstract

A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathorasic blood vessels and for providing anti-bradycardia pacing energy to the heart, comprising a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient's heart; and a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.

What is claimed is:  
     
         1 . A power supply for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathorasic blood vessels and for providing anti-bradycardia pacing energy to the heart, the power supply comprising: 
 a capacitor subsystem for storing the anti-bradycardia pacing energy for delivery to the patient's heart; and    a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.    
     
     
         2 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         3 . The power supply of  claim 2 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         4 . The power supply of  claim 2 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         5 . The power supply of  claim 2 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         6 . The power supply of  claim 2 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         7 . The power supply of  claim 2 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         8 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         9 . The power supply of  claim 8 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         10 . The power supply of  claim 8  wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         11 . The power supply of  claim 8  wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         12 . The power supply of  claim 8  wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         13 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform further comprising a portion that is positive in polarity and a portion that is negative in polarity.  
     
     
         14 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         15 . The power supply of  claim 25 , wherein the biphasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         16 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         17 . The power supply of  claim 16 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         18 . The power supply of  claim 16 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         19 . The power supply of  claim 16 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         20 . The power supply of  claim 16 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         21 . The power supply of  claim 16 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         22 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         23 . The power supply of  claim 22 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         24 . The power supply of  claim 22 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         25 . The power supply of  claim 22 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         26 . The power supply of  claim 22 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         27 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.  
     
     
         28 . The power supply of  claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         29 . The power supply of  claim 28 , wherein the monophasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         30 . Current output system for an implantable cardioverter-defibrillator using a lead system that does not directly contact a patient's heart or reside in the intrathorasic blood vessels and for providing anti-bradycardia pacing energy to the heart, the power supply comprising: 
 an energy storage system for storing the anti-bradycardia pacing energy for delivery to the patient's heart; and    an energy source system electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.    
     
     
         31 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         32 . Current output system of  claim 31 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         33 . Current output system of  claim 31 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         34 . Current output system of  claim 31 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         35 . Current output system of  claim 31 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         36 . Current output system of  claim 31 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         37 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         38 . Current output system of  claim 37 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         39 . Current output system of  claim 37 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         40 . Current output system of  claim 37 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         41 . Current output system of  claim 37 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         42 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform further comprising a positive voltage portion and a negative voltage portion.  
     
     
         43 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         44 . Current output system of  claim 43 , wherein the biphasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         45 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         46 . Current output system of  claim 45 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         47 . Current output system of  claim 45 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         48 . Current output system of  claim 45 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         49 . Current output system of  claim 45 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         50 . Current output system of  claim 45 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         51 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         52 . Current output system of  claim 51 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         53 . Current output system of  claim 51 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         54 . Current output system of  claim 51 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         55 . Current output system of  claim 51 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         56 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.  
     
     
         57 . Current output system of  claim 30 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         58 . Current output system of  claim 57 , wherein the monophasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         59 . An implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib within a patient, the implantable cardioverter-defibrillator comprising: 
 a housing having an electrically conductive surface on an outer surface of the housing;    a lead assembly electrically coupled to the housing and having an electrode, wherein the lead assembly does not directly contact the patient's heart or reside in the intrathorasic blood vessels;    a capacitor subsystem located within the housing and electrically coupled to the electrically conductive surface and the electrode for storing anti-bradycardia pacing energy and for delivering the anti-bradycardia pacing energy to the patient's heart through the electrically conductive surface and the electrode; and    a battery subsystem electrically coupled to the capacitor subsystem for providing the anti-bradycardia pacing energy to the capacitor subsystem.    
     
     
         60 . The implantable cardioverter-defibrillator of  claim 59 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         61 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         62 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         63 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         64 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         65 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         66 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         67 . The implantable cardioverter-defibrillator of  claim 66 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         68 . The implantable cardioverter-defibrillator of  claim 66 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         69 . The implantable cardioverter-defibrillator of  claim 66 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         70 . The implantable cardioverter-defibrillator of  claim 66 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         71 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform further comprising a portion that is positive in polarity and a portion that is negative in polarity.  
     
     
         72 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         73 . The implantable cardioverter-defibrillator of  claim 72 , wherein the biphasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         74 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         75 . The implantable cardioverter-defibrillator of  claim 74 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         76 . The implantable cardioverter-defibrillator of  claim 74 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         77 . The implantable cardioverter-defibrillator of  claim 74 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         78 . The implantable cardioverter-defibrillator of  claim 74 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         79 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         80 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         81 . The implantable cardioverter-defibrillator of  claim 80 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         82 . The implantable cardioverter-defibrillator of  claim 80 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         83 . The implantable cardioverter-defibrillator of  claim 80 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         84 . The implantable cardioverter-defibrillator of  claim 80 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         85 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.  
     
     
         86 . The implantable cardioverter-defibrillator of  claim 60 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         87 . The implantable cardioverter-defibrillator of  claim 86 , wherein the monophasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         88 . A method for supplying power for an implantable cardioverter-defibrillator for subcutaneous positioning between the third rib and the twelfth rib and using a lead system that does not directly contact a patient's heart or reside in the intrathorasic blood vessels and for providing anti-bradycardia pacing energy to the heart, the method comprising: 
 generating anti-bradycardia pacing energy;    storing the anti-bradycardia pacing energy; and    delivering the anti-bradycardia pacing energy to the patient's heart.    
     
     
         89 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         90 . The method of  claim 89 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         91 . The method of  claim 89 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         92 . The method of  claim 89 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         93 . The method of  claim 89 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         94 . The method of  claim 89 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         95 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         96 . The method of  claim 95 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         97 . The method of  claim 95 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         98 . The method of  claim 95 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         99 . The method of  claim 95 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         100 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform further comprising a portion that is positive in polarity and a portion that is negative in polarity.  
     
     
         101 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a biphasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         102 . The method of  claim 101 , wherein the biphasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         103 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 250 milliamps.  
     
     
         104 . The method of  claim 103 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately one milliamp to approximately 50 milliamps.  
     
     
         105 . The method of  claim 103 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 50 milliamps to approximately 100 milliamps.  
     
     
         106 . The method of  claim 103 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 100 milliamps to approximately 150 milliamps.  
     
     
         107 . The method of  claim 103 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 150 milliamps to approximately 200 milliamps.  
     
     
         108 . The method of  claim 103 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak current that is approximately 200 milliamps to approximately 250 milliamps.  
     
     
         109 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 40 milliseconds.  
     
     
         110 . The method of  claim 109 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 1 millisecond to approximately 10 milliseconds.  
     
     
         111 . The method of  claim 109 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 10 milliseconds to approximately 20 milliseconds.  
     
     
         112 . The method of  claim 109 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 20 milliseconds to approximately 30 milliseconds.  
     
     
         113 . The method of  claim 109 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is approximately 30 milliseconds to approximately 40 milliseconds.  
     
     
         114 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.  
     
     
         115 . The method of  claim 88 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of approximately 20 to approximately 120 stimuli/minute.  
     
     
         116 . The method of  claim 115 , wherein the monophasic waveform is provided after a patient's heart rate is greater than or equal to approximately 20 beats/minute.  
     
     
         117 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator is subcutaneously positioned between the third and fourth ribs.  
     
     
         118 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator is subcutaneously positioned between the fourth and sixth ribs.  
     
     
         119 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator is subcutaneously positioned between the sixth and eighth ribs.  
     
     
         120 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator is subcutaneously positioned between the eighth and tenth ribs.  
     
     
         121 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator is subcutaneously positioned between the tenth and twelfth ribs.  
     
     
         122 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator provides anti-bradycardia pacing energy to the heart for treatment of atrial fibrillation.  
     
     
         123 . The method of  claim 88 , wherein the implantable cardioverter-defibrillator provides anti-bradycardia pacing energy to the heart for treatment of ventrical fibrillation.  
     
     
         124 . The power supply of  claim 1 , wherein the battery subsystem and the capacitor system provide a sufficient voltage to provide an anti-bradycardia pacing energy comprising an approximately constant current.