System, adaptor and method to provide medical electrical stimulation

An adaptor for directing electrical stimulation pulse from a first lead to both the first lead and a second lead, the adaptor comprising:

• means for coupling to a pulse generator;
• means for coupling with a first lead and a second lead;
• and
• means for directing pacing stimulation pulses of a first pacing energy level to the first lead and directing pacing stimulation pulses of a second pacing level to the first lead and the second lead wherein the means for directing electrical pacing stimulation pulses of a first pacing amplitude to the first lead and directing electrical pacing stimulation pulses of a second pacing amplitude to the first lead and the second lead comprises a zener diode electrically coupling the second lead to the pulse generator;
• and
• means for sensing through the second electrode, the means for sensing comprising a capacitor and a resistor coupled to the second lead body in parallel to the zener diode wherein electrical signals present at the second electrode may be conducted through the second lead body to the pulse generator.

A method of electrically stimulating either a first chamber of the heart or the first and the second chamber of the heart comprising:

• coupling a first lead to the first chamber the first lead having a first electrode;
• coupling a second lead to the second chamber, the second lead having a second electrode;
• providing means for directing electrical pacing stimulation pulses of a first pacing amplitude to the first electrode and directing electrical pacing stimulation pulses of a second pacing amplitude to the first electrode and the second electrode;
• coupling the first lead and the second lead to the means for directing electrical stimulation pacing pulses;
• providing a pulse generator which emits electrical stimulation pacing pulses of a first pacing amplitude and a second pacing amplitude;
• coupling the means for directing electrical stimulation pacing pulses to the pulse generator;
• emitting electrical stimulation pacing pulses of the first pacing amplitude from the pulse generator;
• directing the electrical stimulation pacing pulses of the first pacing amplitude from the pulse generator to the first electrode;
• emitting electrical stimulation pacing pulses of the second pacing amplitude from the pulse generator;
• and
• directing the electrical stimulation pacing pulses of the second pacing amplitude from the pulse generator to the first electrode and the second electrode.