Method for low-voltage termination of cardiac arrhythmias by effectively unpinning anatomical reentries

A method for treating ventricular tachyarrhythmias in a patient, comprising:

• providing an implantable therapy generator including programmably-operably circuitry to be implanted in a patient and operably connected to a plurality of implantable electrodes;
• and
• configuring the programmably-operably circuitry of the implantable therapy generator to detect and terminate a ventricular tachyarrhythmia, including by:
• establishing a termination window associated with the ventricular tachyarrhythmia;
• and
• deliver an unpinning shock via the plurality of electrodes to the patient within the termination window that generates a relatively low voltage field to create a depolarized region in the heart to extinguish the ventricular tachyarrhythmia by destructively interfering with a reentry wave associated with the ventricular tachyarrhythmias so as to effectively unpin the reentry wave,
• wherein the unpinning shock is delivered at an energy that is higher than conventional anti-tachycardia pacing pulses and lower than an expected lower limit of vulnerability of the patient for the ventricular tachyarrhythmia such that the relatively low voltage field created by the unpinning shock is sufficient to unpin the reentry wave from a location in the heart without increasing a risk of ventricular fibrillation.

A method for controlling an implantable therapy generator adapted to be implanted in a patient and operably connected to a plurality of implantable electrodes, the method comprising configuring the implantable therapy generator to:

• detect a ventricular tachyarrhythmiain a heart of a patient;
• establish a termination window associated with the ventricular tachyarrhythmia;
• within the termination window, deliver an unpinning shock via the plurality of electrodes that generates a relatively low voltage field to depolarize a region in the heart for extinguishing the ventricular tachyarrhythmia by destructively interfering with a reentry wave associated with the ventricular tachyarrhythmia so as to effectively unpin the reentry wave,
• wherein the unpinning shock is delivered at an energy that is higher than conventional anti-tachycardia pacing pulses and lower than an expected lower limit of vulnerability of the patient for the ventricular tachyarrhythmia such that the relatively low voltage field created by the unpinning shock is sufficient to unpin the reentry wave from a location in the heart without increasing a risk of ventricular fibrillation.