Coordinated medium voltage therapy for improving effectiveness of defibrillation therapy

An electrotherapy device for treating arrhythmia in a patient, the device comprising:

• a patient interface including a plurality of electrodes, each having a surface that facilitates electrical contact with the patient;
• electrotherapy circuitry operatively coupled to the patient interface and including:
• a medium voltage therapy (MVT) circuit operatively coupled to the patient interface and constructed to administer MVT via the patient interface to each of a plurality of target regions of the patient, the MVT having an insufficient energy level to shock the heart into a reset state, but having an energy level and a variable waveform that causes musculature in each corresponding target region to be (a) electrically activated into a contracted state, (b) electrically maintained in the contracted state for a compression duration, and (c) thereafter allowed to relax, thereby achieving a forced compression and release of that target region, wherein the plurality of target regions includes a first target region having primarily skeletal musculature, and a second target region having primarily myocardial musculature;
• a high voltage therapy (HVT) circuit operatively coupled to the patient interface and constructed to supply the HVT via the patient interface, wherein the HVT is of an energy level sufficient to shock the heart into a reset state;
• patient monitoring circuitry including an arrhythmia monitoring circuit operatively coupled to the patient interface and configured to measure indicia of an arrhythmia treatable by the HVT;
• and
• a controller circuit operatively coupled to the patient monitoring circuitry and the electrotherapy circuitry, the controller circuit including:
• MVT administration logic configured to cause the electrotherapy circuitry to administer the MVT as a series of repeated, time-coordinated, applications of MVT waveforms to the first and the second target regions, respectively, in response to a detection of a presence of an arrhythmia treatable by the HVT based on an output of the patient monitoring circuitry;
• HVT administration logic configured to cause the electrotherapy circuitry to administer the HVT in response to the detection of the presence of the arrhythmia treatable by the HVT, and in time-coordinated response to a sequence of the time-coordinated applications of the MVT that includes a first MVT waveform to the first target region and a second MVT waveform to the second target region, such that the HVT is synchronized relative to (a) a first compression cycle corresponding to activation of the first target region, and (b) a second compression cycle corresponding to activation of the second target region, resulting from the administration of the MVT.