Implantable electrodes for accomplishing ventricular defibrillation and pacing and method of electrode implantation and utilization

An electrode system for cardiovering a malfunctioning heart, the electrode system comprising:

• first conductive electrode means for associating with a heart in the region of its base;
• second conductive electrode means for associating with the heart in the region of its apex, said second electrode means having first and second conductive surfaces;
• insulation means for insulating the first conductive surface of said second electrode means;
• and first and second electrode leads in electrical contact with the respective first and second electrode means, for applying cardioverting electrical energy between said first and second electrode means for discharge through said heart;
• the second conductive surface of said second electrode means adapted to lie in contact with the heart, and being in a substantially frustoconical shape throughout at least a portion thereof;
• and the insulation means adapted to face away from the heart, and being in a substantially rotated parabola shape.

An electrode for use in a system for cardioverting a malfunctioning heart, the electrode comprising:

• conductive means having first and second conductive surfaces;
• insulation means for insulating the first conductive surface;
• an electrode lead in electrical connection with said conductive means, for applying cardioverting electrical energy to said conductive means for discharge through a heart;
• said second conductive surface adapted to lie in contact with the heart, and being of a substantially frustoconical shape throughout at least a portion thereof;
• and said insulation means adapted to face away from the heart, and being of a substantially rotated parabola shape.

A method of implanting and utilizing an electrode system for cardioverting a malfunctioning heart, the method comprising the steps of:

• opening the chest of a patient;
• positioning a first electrode in the region of the base of the heart;
• positioning a second permanent conformal electrode around the exterior surface of the apex of the heart;
• drawing electrical leads from said first and second electrodes outside the body of the patient;
• closing the chest of said patient with the proximal ends of said electrical leads lying outside the skin of the patient;
• connecting said electrical leads to post-operative defibrillating electronics;
• subsequently incising the patient after said post-operative period;
• implanting a cardioverting pulse generator;
• connecting the pulse generator to the proximal ends of said electrical leads and closing the incision with said electrical leads and said pulse generator beneath the skin of said patient.

A method for implanting cardioverting electrodes, the method consisting of the steps of:

• forming a first cardioverting electrode adapted to associate with the base of the heart;
• forming a second substantially frustoconical cardioverting electrode conforming to the natural shape of the apex of the heart;
• positioning said first electrode in association with the heart in the region of the base thereof;
• inserting said second electrode through an incision in the pericardium;
• and positioning said second electrode around the apex of the heart in the pericardial space.

A method for implanting permanent cardioverting electrodes in a patient whose heart may require cardioversion, the method comprising the steps of:

• implanting a first permanent cardiac electrode in the vicinity of the base of the heart;
• incising the patient to expose the heart;
• implanting a second permanent conformal electrode about and in contact with the periphery of the apex of the heart;
• implanting a pulse generator capable of delivering cardioverting pulses to the heart through the first and second electrodes;
• connecting said first and second electrodes to said pulse generator;
• and closing the incision made in the patient.