Method and apparatus for the monitoring and treatment of spontaneous cardiac arrhythmias

A method for detecting cardiac electrogram features in a patient in need thereof, comprising:

• providing a plurality of subcutaneous sensing electrodes implanted in spatially separate locations in said patient;
• providing an implantable cardiac monitoring device operably associated with said subcutaneous sensing electrodes;
• detecting cardiac electrogram features through said plurality of sensing electrodes;
• and
• storing said detected cardiac electrogram features in said monitoring device.

An implantable defibrillation apparatus that detects and monitors spontaneous cardiac electrogram features in a patient, said apparatus comprising:

• an implantable cardiac defibrillator;
• a plurality of subcutaneous cardiac sensing electrodes electrically connected to said defibrillator, said sensing electrodes configured for sensing cardiac electrogram features when implanted in spatially separate locations in a patient;
• at least one elongate transveneous catheter flexibly configured for insertion into the heart of said patient, said catheter carrying at least one defibrillation electrode and said catheter connected to said defibrillator;
• a detector carried within said defibrillator and operably associated with said sensing electrodes and said at least one defibrillation electrode, said detector configured for detecting the likelihood of a spontaneous cardiac arrhythmia and delivering a treatment pulse through said at least on defibrillation electrode.

A defibrillation method that includes detecting cardiac electrogram features in a patient in need thereof, said method comprising:

• providing a plurality of subcutaneous sensing electrodes implanted in spatially separate locations in said patient;
• providing an implantable cardiac defibrillator operably associated with said subcutaneous sensing electrodes detecting cardiac electrogram features through said plurality of sensing electrodes;
• providing at least one elongate transveneous catheter inserted into the heart of said patient, said catheter connected to said defibrillator and carrying at least one defibrillation electrode;
• detecting electrical activity of the heart of said patient through said subcutaneous sensing electrodes;
• determining the likelihood of a spontaneous cardiac arrhythmia from said detected electrical activity;
• and then
• administering a therapeutic pulse to said heart through said at least one defibrillation electrode upon the determination of a likelihood of occurrence of a spontaneous cardiac arrhythmia.