Charge balanced cardiac pacing from high voltage circuitry of an extra-cardiovascular implantable cardioverter defibrillator system

A method performed by a medical device, the method comprising:

• charging a capacitor that is chargeable to a shock voltage amplitude for delivering a cardioversion/defibrillation shock pulse to a pacing voltage amplitude that is less than the shock voltage amplitude;
• discharging the capacitor charged to the pacing voltage amplitude to deliver a first pulse for pacing a patient's heart, the first pulse having a first polarity;
• and
• delivering a second pulse after the first pulse, the second pulse having a second polarity opposite the first polarity, the second pulse balancing an electrical charge delivered during the first pulse for pacing the patient's heart.

A non-transitory, computer-readable storage medium comprising a set of instructions which, when executed by a control circuit of a medical device, cause the medical device to:

• charge a capacitor that is chargeable to a shock voltage amplitude for delivering a cardioversion/defibrillation shock pulse to a pacing voltage amplitude that is less than the shock voltage amplitude;
• discharge the capacitor charged to the pacing voltage amplitude to deliver a first pulse for pacing a patient's heart, the first pulse having a first polarity;
• and
• deliver a second pulse after the first pulse, the second pulse having a second polarity opposite the first polarity, the second pulse balancing an electrical charge delivered during the first pulse for pacing the patient's heart.