Arrhythmia electrotheraphy device and method with provisions for mitigating patient discomfort

An electrotherapy apparatus adapted for subcutaneous implantation for applying far-field pacing therapy for treating a patient experiencing an arrhythmia, the apparatus comprising:

• a power source adapted to supply energy for operation of the apparatus;
• electrotherapy administration circuitry electrically coupled to the power source and to a set of patient terminals, and constructed to generate electrotherapy pulses using the energy from the power source and apply a series of the electrotherapy pulses via the patient terminals in response to a control signal, the electrotherapy pulses being far-field pacing pulses, each delivering sufficient charge, through a set of sensing electrodes positioned subcutaneously in far-field relation relative to a heart of the patient, to initiate a cardiac cycle, the sensing electrodes including a sensing electrode located at each end of a main stimulation coil providing and configured to substantially embody the end of the main stimulation coil to create an edge effect that tapers a voltage present on the main stimulation coil, thereby reducing a current density in a vicinity of the edge effect;
• monitoring circuitry electrically coupled with the power source and the set of patient terminals, and constructed to monitor the patient for indicia of the arrhythmia;
• and
• controller circuitry electrically coupled with the power source, the electrotherapy administration circuitry, and the monitoring circuitry, the controller circuitry including a processor and a data storage device containing instructions that, when executed by the processor, cause the controller circuitry to read an output of the monitoring circuitry and determine any presence of the arrhythmia based on that output, and to generate the control signal causing the electrotherapy administration circuitry to apply the series of electrotherapy pulses.

A method for treating an arrhythmia in a patient using an electrotherapy device, the method comprising:

• monitoring, by the electrotherapy device, the patient for indicia of the arrhythmia;
• determining, by the electrotherapy device, the presence of the arrhythmia based on the indicia;
• and
• applying to the patient, by the electrotherapy device, a series of electrotherapy pulses in response to the presence of the arrhythmia through a set of sensing electrodes positioned subcutaneously in far-field relation relative to a heart of the patient to initiate a cardiac cycle, the sensing electrodes including a sensing electrode located at each end of a main stimulation coil providing and configured to substantially embody the end of the main stimulation coil to create an edge effect that tapers a voltage present on the main stimulation coil, thereby reducing a current density in a vicinity of the edge effect.