Pulsed electric field ablation for implantable medical devices

A medical system, comprising:

• an active implantable medical device including a first wireless transceiver;
• a programmer head including a second wireless transceiver, the first wireless transceiver and the second wireless transceiver being configured to wirelessly transmit data therebetween;
• and
• an electronic programmer connected to the programmer head,
• wherein the active implantable medical device comprises:
• a plurality of electrodes including a first electrode and a second electrode;
• an implantable device box configured to be implanted into a pocket of a patient body outside the heart, wherein the third electrode is along an exterior surface of the device box;
• an electrical circuit in an interior portion of the implantable device box, the electrical circuit being electrically connectable to the plurality of electrodes to apply thereto electrical pulses according to a first modality and according to a different second modality;
• and
• a first electrical lead having a proximal end connectable to the electrical circuit and further having a distal portion implantable into a heart, the distal portion including the first electrode and the second electrode;
• and
• wherein the electrical circuit is configured to apply a defibrillation pulse to the first electrode in the first modality and to apply an ablation pulse between the second electrode and the third electrode in the different second modality, the defibrillation pulse and the ablation pulse being different in at least one of a pulse amplitude and a pulse width;
• and
• wherein the second and third electrodes are configured to cause an electrical current to pass through tissue targeted for ablation therapy, the tissue being selected from the group consisting of a sinoatrial node of the heart, an atrioventricular node of the heart, and a premature ventricular contraction area of the heart.