Summation anodal pacing to complement multisite stimulation

A method of cardiac pacing, the method comprising the steps of:

• providing a device comprising:
• a current source;
• a plurality of leads which are connected to the current source, wherein each lead is connected to at least one of a right atrium of a heart, a right ventricle of the heart, a left atrium of the heart, and a left ventricle of the heart;
• wherein at least one electrode is associated with each of the leads and at least two electrodes are associated with at least one of the leads, wherein at least one electrode serves as a cathode and at least one electrode serves as an anode, wherein an anodal surface area is sized to cause anodal capture;
• and
• delivering solely cathodal stimulus current to at least one electrode wherein at least one other electrode is a return electrode and the stimulus creates an area of depolarization of one part of the myocardial cell membrane and resultant cathodal stimulation and hyper-polarization of another part the myocardial cell membrane and resultant anodal capture of another portion of the heart via the return electrode, wherein the return electrode is a pacing electrode, wherein the cathodal stimulation and the anodal capture are simultaneous and the anodal capture of the another portion of the heart as a result of the stimulation occurs solely as a consequence of the cathodal stimulation of another electrode.

A device for applying an electrical current to a heart, the device comprising:

• a current source;
• a plurality of leads which are connected to the current source,
• wherein the leads include first, second, and third leads that are connectable to a right atrium of a heart, a right ventricle of the heart, and a left ventricle of the heart, respectively;
• wherein each of the leads has at least one electrode and at least the third lead has at least two electrodes,
• wherein at least one of the electrodes serves as a cathode and at least one of the electrodes serves as an anode,
• wherein a surface area of at least one of the electrodes is sized sufficiently small to cause anodal capture,
• wherein the current source is controlled to deliver solely cathodal stimulation to at least one electrode,
• wherein at least one other electrode is a return electrode,
• wherein the stimulation creates an area of hyper-polarization of the myocardial cell membrane and resultant anodal capture of a portion of the heart via the return electrode,
• wherein the return electrode is a pacing electrode, and
• wherein cathodal stimulation is simultaneous with anodal capture that occurs solely as a consequence of the cathodal stimulation of another electrode.

A device for applying an electrical current to a heart, the device comprising:

• a current source;
• a plurality of leads which are connected to the current source,
• wherein the leads include first, second, and third leads that are connectable to a right atrium of a heart, a right ventricle of the heart, and a left ventricle of the heart, respectively;
• wherein each of the leads has at least one electrode and the third lead has at least four electrodes,
• wherein at least one of the electrodes serves as a cathode and at least one of the electrodes serves as an anode,
• wherein a surface area of at least one of the electrodes is sized sufficiently small to cause anodal capture,
• wherein the current source is controlled to deliver solely cathodal stimulation to at least one electrode,
• wherein at least one other electrode is a return electrode,
• wherein the stimulation creates an area of hyper-polarization of the myocardial cell membrane and resultant anodal capture of a portion of the heart via the return electrode,
• wherein the return electrode is a pacing electrode, and
• wherein cathodal stimulation is simultaneous with anodal capture that occurs solely as a consequence of the cathodal stimulation of another electrode.

A device for applying an electrical current to a heart, the device comprising:

• a current source;
• a plurality of leads which are connected to the current source,
• wherein the leads include first, second, and third leads that are connectable to a right atrium of a heart, a right ventricle of the heart, and a left ventricle of the heart, respectively;
• wherein each of the leads has at least one electrode and the third lead has at least four electrodes,
• wherein at least one of the electrodes serves as a cathode and at least one of the electrodes serves as an anode,
• wherein a surface area of at least one of the electrodes is sized sufficiently small to cause anodal capture,
• wherein the current source is controlled to deliver solely cathodal stimulation to at least one electrode,
• wherein at least one other electrode is a return electrode,
• wherein the stimulation creates an area of hyper-polarization of the myocardial cell membrane and resultant anodal capture of a portion of the heart via the return electrode,
• wherein the return electrode is a pacing electrode,
• wherein cathodal stimulation is simultaneous with anodal capture that occurs solely as a consequence of the cathodal stimulation of another electrode,
• wherein the third lead is a quadripolar lead having four electrodes,
• wherein at least one electrode of the third lead serves as a cathode and at least one electrode of the third lead serves as an anode,
• wherein the second lead is a bipolar lead having a proximal electrode and a tip electrode, and
• wherein the proximal electrode on the bipolar lead has a surface area that is at least 7 times a surface area of the tip electrode on the bipolar lead.

A method of cardiac pacing, the method comprising the steps of:

• providing a device comprising:
• a current source;
• a plurality of leads which are connected to the current source, wherein each lead is connected to at least one of a right atrium of a heart, a right ventricle of the heart, a left atrium of the heart, and a left ventricle of the heart, wherein each of the first and second leads has at least one electrode and the third lead has at least four electrodes;
• wherein at least one electrode is associated with each of the leads and at least two electrodes are associated with at least one of the leads, wherein at least one electrode serves as a cathode and at least one electrode serves as an anode,
• wherein an anodal surface area is sized to cause anodal capture;
• and
• delivering solely cathodal stimulus current to at least one electrode wherein at least one other electrode is a return electrode and the stimulus creates an area of depolarization of one part of the myocardial cell membrane and resultant cathodal stimulation and hyper-polarization of another part the myocardial cell membrane and resultant anodal capture of another portion of the heart via the return electrode, wherein the return electrode is a pacing electrode, wherein the cathodal stimulation and the anodal capture are simultaneous and the anodal capture of the another portion of the heart as a result of the stimulation occurs solely as a consequence of the cathodal stimulation of another electrode.