Apparatus for detecting and treating ventricular arrhythmia

Abstract

A system and method for long-term monitoring of cardiac conditions such as arrhythmias is disclosed. The invention includes a pulse generator including means for sensing an arrhythmia. The pulse generator is coupled to at least one subcutaneous electrode or electrode array for providing electrical stimulation such as cardioversion/defibrillation shocks and/or pacing pulses. The electrical stimulation may be provided between multiple subcutaneous electrodes, or between one or more such electrodes and the housing of the pulse generator. In one embodiment, the pulse generator includes one or more electrodes that are isolated from the can. These electrodes may be used to sense cardiac signals.

1 . A system for providing arrhythmia therapy to a patient, comprising: 
 an implantable pulse generator;    a sensing circuit coupled to the implantable pulse generator; and    a subcutaneous electrode array coupled to the implantable pulse generator to deliver electrical stimulation to the patient upon detection by the sensing circuit of an arrhythmia.    
   
   
       2 . The system of  claim 1 , wherein the subcutaneous electrode array is a defibrillation electrode array to deliver relatively high-voltage electrical stimulation to the patient.  
   
   
       3 . The system of  claim 1 , wherein the sensing circuit includes a circuit to sense a bradyarrhythmia event, and wherein the subcutaneous electrode array is configured to deliver at least one pacing pulse to the patient upon detection of the bradyarrhythmia event.  
   
   
       4 . The system of  claim 1 , wherein the system is housed within a can, and wherein the sensing circuit includes at least two sensing electrodes on at least a first surface of the can to sense cardiac signals.  
   
   
       5 . The system of  claim 2 , wherein the system is housed within a can, and wherein the sensing circuit utilizes the defibrillation electrode array and the can to sense for an arrhythmia.  
   
   
       6 . The system of  claim 1 , wherein the can includes at least one surface to deliver high-voltage shocks.  
   
   
       7 . The system of  claim 4 , wherein the can includes at least one surface to deliver high-voltage shocks, and wherein the surface to deliver high-voltage shocks is different from the at least first surface of the can.  
   
   
       8 . A method for treating patient arrhythmias, including the methods of: 
 a.) providing a subcutaneous pulse generator;    b.) providing a monitoring circuit to monitor the patient's cardiac signals for arrhythmias; and    c.) providing a subcutaneous electrode array to deliver electrical therapy to a patient.    
   
   
       9 . A method of using a subcutaneously-placed pulse generator to treat arrhythmias, including the methods of: 
 a.) detecting an arrhythmia; and    b.) employing at least one subcutaneous electrode to deliver therapy based on the detected arrhythmia.    
   
   
       10 . The method of  claim 9 , wherein the detected arrhythmia is a tachyarrythmia, wherein the at least one subcutaneous electrode includes a defibrillation electrode, and wherein the therapy that is delivered is a relatively high-voltage shock.  
   
   
       11 . The method of  claim 9 , wherein the detected arrhythmia is a bradyarrythmia, and wherein step b includes delivering a pacing pulse in response to the detected bradyarrythmia.  
   
   
       12 . A system for delivering electrical energy to the heart of a patient, the system comprising: 
 a subcutaneous pulse generator;    at least one sensing electrode disposed on a surface of the pulse generator and positioned proximate to subcutaneous tissue; and    at least one electrode array coupled to the pulse generator and positioned subcutaneously on the patient.    
   
   
       13 . An apparatus for monitoring cardiac signals of a patient, comprising; 
 a hermetically-sealed housing;    sensing means included within the housing; and    first and second electrode sets coupled to the sensing means, the first electrode set including at least one electrode adjacent to a surface of the housing positionable proximate subcutaneous tissue at a first location in the patient's body, and the second electrode set coupled to a connector on the housing and forming an electrode array subcutaneously positionable in the patient's body at a location different from the first location.