Systems and methods for packed pacing using bifurcated pacing pulses of opposing polarity generated by an implantable medical device

A system for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the system comprising:

• a single-phase primary pulse packed pacing system operative during a first cardiac cycle to generate a plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes during the first cardiac cycle, wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse;
• and
• a single-phase secondary pulse packed pacing system operative during a second cardiac cycle to generate a plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient during the second cardiac cycle with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes, the secondary pulses being opposite in polarity to the primary pulses and configured as recharge pulses in relation to corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single phase pulse.

A system for use with an implantable cardiac stimulation device equipped for delivering output pulses via a plurality of electrodes, the system comprising:

• means, operative during a first cardiac cycle, for generating a plurality of closely spaced single-phase primary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of primary pulses being delivered using a different pair of electrodes during the first cardiac cycle, wherein an amplitude of the primary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single pulse:
• and
• means, operative during a second cardiac cycle, for generating a plurality of closely spaced single-phase secondary stimulation pulses for delivery to the heart of the patient with each pulse of the plurality of secondary stimulation pulses being delivered using a different pair of electrodes during the second cardiac cycle, the secondary pulses being opposite in polarity to the primary pulses and configured as recharge pulses in relation to corresponding primary pulses, wherein an amplitude of the secondary stimulation pulses is higher than a stimulation threshold at each of the different pairs of electrodes for the corresponding single pulse.