Inter-atrial septum electrode for atrial defibrillation

A method for the defibrillation or cardioversion of the heart of a patient in need thereof while minimizing the voltage of defibrillation pulses to be delivered, said method comprising the steps of:

• positioning first and second defibrillation electrodes in operable association with the heart of said subject, said first and second defibrillation electrodes defining a gradient field in said heart, said gradient field including a region of said heart to be defibrillated;
• positioning a third electrode in said gradient field between said first and second electrodes;
• and then
• concurrently delivering (a) a first defibrillation pulse between said first and third electrode and (b) a second defibrillation pulse between said second and third electrodes;
• with said first and second defibrillation pulses together effective to defibrillate said heart;
• and with the voltage required for each of said first and second defibrillation pulses being less than the voltage necessary for a single defibrillation pulse delivered between said first and second electrodes that is effective to defibrillate said heart.

A method for the defibrillation or cardioversion of the atria of the heart of a patient in need thereof, said method comprising the steps of:

• positioning a first defibrillation electrode in the right atrium, superior vena cava or right ventricle of said subject;
• positioning a second defibrillation electrode in the coronary sinus or a vein on the surface of the left ventricle of said heart;
• positioning a third electrode at the atrial septum of said heart;
• and then
• concurrently delivering (a) a first defibrillation pulse between said first and third electrode and (b) a second defibrillation pulse between said second and third electrodes;
• with each of said first and second defibrillation pulses having an energy not greater than four Joules,
• and with said first and second defibrillation pulses being delivered within 500 milliseconds of each other.

A method for the defibrillation or cardioversion of the atria of the heart of a patient in need thereof, said method comprising the steps of:

• positioning a first defibrillation electrode in the right atrium, superior vena cava or right ventricle of said subject;
• positioning a second defibrillation electrode in the coronary sinus or a vein on the surface of the left ventricle of said heart;
• positioning a third electrode at the atrial septum of said heart;
• and then
• concurrently delivering (a) a first defibrillation pulse between said first and third electrode and (b) a second defibrillation pulse between said second and third electrodes;
• with each of said first and second defibrillation pulses having an energy not greater than four Joules, and with said first and second defibrillation pulses being delivered within 500 milliseconds of each other, wherein
• said first and second electrodes are carried by a first transveneous catheter, said first transveneous catheter having an intermediate portion;
• said third electrode is carried by a second transveneous catheter, said second transveneous catheter having a distal end portion;
• and
• said second transveneous catheter distal end portion is connected to said first transveneous catheter intermediate portion.

An implantable system for the defibrillation or cardioversion of a patient's heart, said system comprising:

• first and second defibrillation electrodes configured for positioning in operable association with the heart of said subject, said first and second defibrillation electrodes when so positioned defining a gradient field in said heart between said first and second electrodes and in a region to be defibrillated;
• a third defibrillation electrode configured for positioning in said gradient field between said first and second electrodes;
• and
• a pulse generator operatively associated with said first, second and third defibrillation electrodes and configured for concurrently delivering (a) a first defibrillation pulse between said first and third electrode and (b) a second defibrillation pulse between said second and third electrodes, with the voltage required for each of said first and second defibrillation pulses being less than the voltage required for a single defibrillation pulse delivered between said first and second electrodes.

An implantable system for the defibrillation or cardioversion of a patient's heart, said system comprising:

• first and second defibrillation electrodes configured for positioning in operable association with the heart of said subject, said first and second defibrillation electrodes when so positioned defining a gradient field in said heart between said first and second electrodes and in a region to be defibrillated;
• a third defibrillation electrode configured for positioning in said gradient field between said first and second electrodes;
• a pulse generator operatively associated with said first, second and third defibrillation electrodes and configured for concurrently delivering (a) a first defibrillation pulse between said first and third electrode and (b) a second defibrillation pulse between said second and third electrodes with the voltage required for each of said first and second defibrillation pulses being less than the voltage required for a single defibrillation pulse delivered between said first and second electrodes;
• wherein said first, second and third electrodes are carried by said first and second transveneous catheters, and wherein said first transveneous catheter is fixed to said second transveneous catheter.