Method and apparatus for hospital, EMT/EMS, and AED grade external defibrillation and transcutaneous pacing

An apparatus for external treatment of a cardiac condition in a patient, comprising:

• at least two multi-external electrode patches or paddles for contacting an area of the outer surface of skin of the patient;
• a pre-stimulus servo amplifier array;
• and
• an external waveform energy software control system which comprises:
• an electronic system containing a microcontroller programmed with software;
• and
• external differentially driven amplifier circuits having an input and an output,
• wherein the microcontroller is operatively connected to the input of the differentially driven amplifier circuits, the microcontroller is configured to respond to software commands to generate signals to the input of the differentially driven amplifier circuits, and the output of the differentially driven amplifier circuits externally delivers constant current, constant energy, or constant voltage ascending arbitrary ramp waveforms, biphasic truncated exponential (BTE) waveforms, or ascending arbitrary and BTE descending waveforms, transcutaneous pacing, low voltage therapies, defibrillation, or cardioversion electrical shocks through the at least two external multi-electrode patches or paddles, through the patient's skin, to the patient's heart, and
• wherein in a first step the pre-stimulus servo amplifier array delivers a low-voltage electrical current beneath the at least two external multi-electrode patches or paddles in a rotational manner to pre-stimulate that area, causing chest muscle beneath the multi-electrode patches or paddles to contract to an absolute refractory period and lowering chest muscle impedance, thereby providing a low impedance chest pathway using less energy compared to standard defibrillation devices, and
• wherein in a second step the differentially driven amplifier circuits deliver a high voltage arbitrary waveform shock from the multi-electrode patches or paddles through the patient's chest and heart to cause defibrillation, cardioversion, or defibrillation and cardioversion.

A system for external treatment of a cardiac condition in a patient, comprising:

• at least two external multi-electrode patches or paddles for contacting an area of the outer surface of skin of the patient;
• a pre-stimulus servo amplifier array;
• and
• an external waveform energy software control system which comprises a microcontroller;
• and
• differentially driven amplifier circuits having an input and an output,
• wherein the microcontroller is operatively connected to the input of the differentially driven amplifier circuits, the microcontroller is configured to respond to software commands to generate signals to the input of the differentially driven amplifier circuits, and the output of the differentially driven amplifier circuits externally delivers defibrillation or cardioversion electrical shocks through the at least two external multi-electrode patches or paddles, through the patient's chest, to the patient's heart, and
• wherein in a first step the pre-stimulus servo amplifier array delivers a low-voltage electrical current beneath the at least two external multi-electrode patches or paddles in a rotational manner to pre-stimulate that area, causing chest muscle beneath the multi-electrode patches or paddles to contract to an absolute refractory period and lowering chest muscle impedance, thereby providing a low impedance chest pathway using less energy compared to standard defibrillation devices, and
• wherein in a second step the differentially driven amplifier circuits deliver a high voltage arbitrary waveform shock from the multi-electrode paddles or patches through the patient's chest and heart to cause defibrillation, cardioversion, or defibrillation and cardioversion.