Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
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 intrathoracic 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.
1. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:
subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;
using a lead system that does not directly contact a patient's heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;
generating the anti-bradycardia pawing energy;
storing the anti-bradycardia pacing energy; and
delivering the anti-bradycardia pacing energy to the patient's heart;
wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 25 volts and approximately 50 volts.
2. The method of claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is either positive or negative in polarity.
3. The method of claim 2 , wherein the monophasic waveform has a tilt of between approximately 5% and approximately 95%.
4. The method of claim 3 , wherein the tilt is approximately 50%.
5. The method of claim 1 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform that is provided at a rate of between approximately 20 and approximately 120 stimuli/minute.
6. The method of claim 5 , wherein the monophasic waveform is provided after a patient's heart rate is equal or less than approximately 20 beats/minute.
7. The method of claim 1 , wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the third and fifth ribs.
8. The method of claim 1 , wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the fourth and sixth ribs.
9. The method of claim 1 , wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the sixth and eighth ribs.
10. The method of claim 1 , wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the eight and tenth ribs.
11. The method of claim 1 , wherein the implantable cardioverter-defibrillator is positioned subcutaneously between the tenth and twelfth ribs.
12. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:
subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;
using a lead system that does not directly contact the patient's heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;
generating anti-bradycardia pacing energy;
storing the anti-bradycardia pacing energy; and
delivering the anti-bradycardia pacing energy to the patient's heart;
wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 50 volts and approximately 75 volts.
13. A method for supplying anti-bradycardia pacing energy with an implantable cardioverter-defibrillator (ICD) comprising:
subcutaneously positioning the ICD between the third rib and the twelfth rib of a patient;
using a lead system that does not directly contact the patient's heart or reside in the intrathoracic blood vessels to provide the anti-bradycardia pacing energy to the heart;
generating anti-bradycardia pacing energy;
storing the anti-bradycardia pacing energy; and
delivering the anti-bradycardia pacing energy to the patient's heart;
wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between 1 millisecond and approximately 40 milliseconds.
14. The method of claim 13 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 0.1 volts and approximately 100 volts.
15. The method of claim 14 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 0.1 volts and approximately 25 volts.
16. The method of claim 14 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a peak voltage that is between approximately 25 volts and approximately 50 volts.
17. The method of claim 13 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 2 milliseconds and approximately 10 milliseconds.
18. The method of claim 13 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 10 milliseconds and approximately 20 milliseconds.
19. The method of claim 13 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 20 milliseconds and approximately 30 milliseconds.
20. The method of claim 13 , wherein the anti-bradycardia pacing energy comprises a monophasic waveform having a pulse width that is between approximately 30 milliseconds and approximately 40 milliseconds.