Ceramics and/or other material insulated shell for active and non-active S-ICD can

1. An implantable cardioverter-defibrillator comprising:

a housing including a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device;

an electrode disposed on the housing; wherein the insulating plates separate the conductive plates from the electrode; and

cardioversion-defibrillation circuitry located within the housing and coupled to the electrode.

2. A subcutaneous cardioverter-defibrillator comprising:

a housing comprising a mixture of conductive and nonconductive materials, the housing having a top surface and a bottom surface;

an electrical circuit located within the housing; and

an electrode integrally positioned on a portion of the housing, wherein the electrode couples to the electrical circuit, and further wherein the electrode can provide an effective electric field to treat the myocardium;

wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device; wherein the insulating plates separate the conductive plates from the electrode.

3. A cardioverter-defibrillator comprising:

an electrode;

a housing comprising a mixture of conductive and nonconductive materials wherein the electrode is integrally disposed in the housing such that the electrode is maintained in a predetermined relationship subcutaneously over a patient's ribs; and

cardioversion-defibrillation circuitry located within the housing and coupled to the electrode;

wherein the housing comprises a mixture of ceramic materials and titanium; and

wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device; wherein the insulating plates separate the conductive plates from the electrode.

4. A subcutaneous cardioverter-defibrillator comprising:

a housing having a top surface and a bottom surface, wherein at least a portion of the bottom surface of the housing is non planar, wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device;

an electrical circuit located within the housing; and

an electrode integrally positioned on a portion of the housing, wherein the insulating plates separate the conductive plates from the electrode, wherein the electrode couples to the electrical circuit, and further wherein the electrode can provide an effective electric field for myocardial cardioversion and defibrillation.

5. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the housing comprises an electrically insulated material.

6. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the housing comprises a ceramic material.

7. The subcutaneous cardioverter defibrillator of claim 6 , wherein the ceramic material is selected from the group consisting essentially of zirconia, alumina, silicon nitride, silicon carbide, titanium carbide, tungsten carbide, titanium nitride, silicon-aluminum oxy-nitride (sialon), graphite, titanium di-boride, boron carbide, zirconia toughened alumina, and molybdenum disilicide.

8. The cardioverter-defibrillator of claim 7 , wherein the zirconia is selected from the group consisting essentially of stabilized zirconia, partially stabilized zirconia, tetragonal zirconia, yttria-stabilized zirconia, magnesia-stabilized zirconia, ceria-stabilized zirconia, and calcia-stabilized zirconia.

9. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the housing comprises a mixture of ceramic and titanium.

10. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the portion of the bottom surface of the housing being non planar comprises a circular arc.

11. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the portion of the bottom surface of the housing being non planar comprises an elliptical arc.

12. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the portion of the bottom surface of the housing being non planar comprises a nonsymmetrical arc.

13. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the bottom surface of the housing is substantially smooth.

14. The subcutaneous cardioverter-defibrillator of claim 4 , wherein a portion of the top surface of the housing is substantially non planar.

15. The subcutaneous cardioverter-defibrillator of claim 14 , wherein the portion of the top surface of the housing being non planar comprises a circular arc.

16. The subcutaneous cardioverter-defibrillator of claim 14 , wherein the portion of the top surface of the housing being non planar comprises an elliptical arc.

17. The subcutaneous cardioverter-defibrillator of claim 14 , wherein the portion of the top surface of the housing being non planar comprises a nonsymmetrical arc.

18. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the top surface of the housing is substantially smooth.

19. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the bottom surface further comprises a proximal end and a distal end, wherein the electrode is integrally positioned at the proximal end of the bottom surface.

20. The subcutaneous cardioverter-defibrillator of claim 19 , wherein a second electrode is integrally positioned at the distal end of the bottom surface.

21. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the electrical circuit can provide cardioversion-defibrillation energy for the patient's heart.

22. The subcutaneous cardioverter-defibrillator of claim 21 , wherein the electrical circuit further provides biphasic waveform cardiac pacing for the patient's heart.

23. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the electrical circuit provides biphasic waveform cardiac pacing for the patient's heart.

24. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the electrode emits an energy for treating the patient's heart.

25. The subcutaneous cardioverter-defibrillator of claim 24 , wherein the electrode further receives sensory information.

26. The subcutaneous cardioverter-defibrillator of claim 4 , wherein the electrode receives sensory information.

27. 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, wherein at least a portion of the housing is curved, wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device;

an electrical circuit; and

an electrically conductive surface integrally positioned on a portion of the housing, wherein the electrically conductive surface is coupled to the electrical circuit; wherein the insulating plates separate the conductive plates from the conductive surface.

28. The implantable cardioverter-defibrillator of claim 27 , wherein the housing comprises an electrically insulated material.

29. The implantable cardioverter-defibrillator of claim 27 , wherein the housing comprises a ceramic material.

30. The implantable cardioverter-defibrillator of claim 29 , wherein the ceramic material is selected from the group consisting essentially of zirconia, alumina, silicon nitride, silicon carbide, titanium carbide, tungsten carbide, titanium nitride, silicon-aluminum oxy-nitride (sialon), graphite, titanium di-boride, boron carbide, zirconia toughened alumina, and molybdenum disilicide.

31. The implantable cardioverter-defibrillator of claim 30 , wherein the zirconia is selected from the group consisting essentially of stabilized zirconia, partially stabilized zirconia, tetragonal zirconia, yttria-stabilized zirconia, magnesia-stabilized zirconia, ceria-stabilized zirconia, and calcia-stabilized zirconia.

32. The implantable cardioverter-defibrillator of claim 27 , wherein the housing comprises a mixture of ceramic materials and titanium.

33. The implantable cardioverter-defibrillator of claim 27 , wherein at least a portion of the first segment is curved.

34. The implantable cardioverter-defibrillator of claim 27 , wherein at least a portion of the second segment is curved.

35. The implantable cardioverter-defibrillator of claim 27 , wherein the curved portion of the housing comprises a circular arc.

36. The implantable cardioverter-defibrillator of claim 27 , wherein the curved portion of the housing comprises an elliptical arc.

37. The implantable cardioverter-defibrillator of claim 27 , wherein the curved portion of the housing comprises a nonsymmetrical arc.

38. The implantable cardioverter-defibrillator of claim 34 , wherein the curved portion of the second segment comprises a circular arc.

39. The implantable cardioverter-defibrillator of claim 34 , wherein the curved portion of the second segment comprises an elliptical arc.

40. The implantable cardioverter-defibrillator of claim 34 , wherein the curved portion of the second segment comprises a nonsymmetrical arc.

41. The implantable cardioverter-defibrillator of claim 27 , wherein the second segment of the housing is substantially straight.

42. The implantable cardioverter-defibrillator of claim 27 , wherein the first segment of the housing is contiguous with the second segment of the housing.

43. The implantable cardioverter-defibrillator of claim 27 , wherein the electrical circuit provides cardioversion-defibrillation energy for the patient's heart.

44. The implantable cardioverter-defibrillator of claim 43 , wherein the electrical circuit further provides biphasic waveform cardiac pacing for the patient's heart.

45. The implantable cardioverter-defibrillator of claim 27 , wherein the electrical circuit provides biphasic waveform cardiac pacing for the patient's heart.

46. The implantable cardioverter-defibrillator of claim 27 , wherein the electrically conductive surface emits an energy for shocking the patient's heart.

47. The implantable cardioverter-defibrillator of claim 46 , wherein the electrically conductive surface further receives sensory information.

48. The implantable cardioverter-defibrillator of claim 27 , wherein the electrically conductive surface can receive sensory information.

49. A cardioverter-defibrillator comprising:

an electrode;

a housing having a curved portion, wherein the electrode is integrally disposed in the curved portion of the housing such that the electrode is maintained in a predetermined relationship subcutaneously over a patient's ribs, and wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment is coupled to the conductive plate of the second segment to form a unitary implantable device, and wherein the insulating plates separate the conductive plates from the electrode; and

cardioversion-defibrillation circuitry located within the housing and coupled to the electrode.

50. The cardioverter-defibrillator of claim 49 , wherein the electrode emits energy for shocking a patient's heart.

51. The cardioverter-defibrillator of claim 50 , wherein the electrode further receives sensory information.

52. The cardioverter-defibrillator of claim 49 , wherein the electrode receives sensory information.

53. The cardioverter-defibrillator of claim 49 , wherein the housing comprises a ceramic material.

54. The cardioverter-defibrillator of claim 53 , wherein the ceramic material is selected from the group consisting essentially of zirconia, alumina, silicon nitride, silicon carbide, titanium carbide, tungsten carbide, titanium nitride, silicon-aluminum oxy-nitride (sialon), graphite, titanium di-boride, boron carbide, zirconia toughened alumina, and molybdenum disilicide.

55. The cardioverter-defibrillator of claim 54 , wherein the zirconia is selected from the group consisting essentially of stabilized zirconia, partially stabilized zirconia, tetragonal zirconia, yttria-stabilized zirconia, magnesia-stabilized zirconia, ceria-stabilized zirconia, and calcia-stabilized zirconia.

56. The cardioverter-defibrillator of claim 55 , wherein the housing comprises a mixture of ceramic materials and titanium.

57. The cardioverter-defibrillator of claim 49 , wherein the curved portion of the housing comprises a circular arc.

58. The cardioverter-defibrillator of claim 57 , wherein the circular arc is approximately 1 radians to approximately 180 radians in length.

59. The cardioverter-defibrillator of claim 49 , wherein the curved portion of the housing comprises an elliptical arc.

60. The cardioverter-defibrillator of claim 49 , wherein the curved portion of the housing comprises a nonsymmetrical arc.

61. The cardioverter-defibrillator of claim 49 , wherein the predetermined relationship is with respect to the patient's heart.

62. The cardioverter-defibrillator of claim 49 , wherein the cardioversion-defibrillation circuitry further provides waveform cardiac pacing for a patient's heart.

63. 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 comprising a mixture of conductive and nonconductive materials wherein at least a portion of the housing is curved;

an electrical circuit; and

an electrode integrally positioned on a portion of the housing, wherein the electrode is coupled to the electrical circuit;

wherein the housing further comprises a first segment and a second segment, each segment having an insulating plate at an end thereof and a conductive plate coupled to the insulating plate, wherein the conductive plate of the first segment can be coupled to the conductive plate of the second segment to form a unitary implantable device; wherein the insulating plates separate the conductive plates from the electrode.

64. The implantable cardioverter-defibrillator of claim 63 , wherein at least a portion of the first segment is curved.

65. The implantable cardioverter-defibrillator of claim 63 , wherein at least a portion of the second segment is curved.

66. The implantable cardioverter-defibrillator of claim 65 , wherein the curved portion of the second segment comprises a circular arc.

67. The implantable cardioverter-defibrillator of claim 65 , wherein the curved portion of the second segment comprises an elliptical arc.

68. The implantable cardioverter-defibrillator of claim 65 , wherein the curved portion of the second segment comprises a nonsymmetrical arc.

69. The implantable cardioverter-defibrillator of claim 63 , wherein the second segment of the housing is substantially straight.

70. The implantable cardioverter-defibrillator of claim 63 , wherein the first segment of the housing is contiguous with the second segment of the housing.