A multipart, non-uniform patient contact interface and method of use are disclosed.

A defibrillation system for synchronized cardioversion of a patient includes a first housing that includes a measurement circuit configured to receive electrocardiogram (ECG) signals and measure ECG parameters based on the ECG signals, and a first processor configured to analyze the ECG parameters, and initiate communication of a synchronization signal for a second processor for delivery of one or more defibrillation pulses and further includes a second housing that is separate from and external to the first housing and that includes a shock delivery circuit, and the second processor which is configured to receive the communication of the synchronization signal from the first processor, and control the shock delivery circuit to deliver the one or more defibrillation pulses in response to the synchronization signal.

A wearable monitoring and therapeutic device includes at least two sensing electrodes, including at least one of conductive thread sewn into a garment and/or a metallic surface sewn into the garment. The device includes at least two therapy electrodes and the garment, wherein the garment is configured to be worn about a torso of a subject. The garment includes a breathable and stretchable fabric, an elastic material, and a loose material. The device includes at least one defibrillator component including a power source, a conductive wiring configured to stretch to accommodate the subject's chest size and enhance comfort and couple any of the at least two therapy electrodes and the at least two sensing electrodes to the at least one defibrillator component, an alarm module operatively coupled to the at least one defibrillator component, and one or more response buttons operatively coupled to that at least one defibrillator component.

Methods and apparatus for a three-stage ventricular cardioversion and defibrillation therapy that treats ventricular tachycardia and fibrillation at low energy levels. An implantable therapy generator adapted to generate and selectively deliver a three-stage ventricular therapy and at least two leads operably each having at least one electrode adapted to be positioned proximate the ventricle of the patient. The device is programmed to deliver a three-stage therapy via both a far-field configuration and a near-field configuration of the electrodes upon detection of a ventricular arrhythmia. The three-stage therapy includes a first stage for unpinning of one or more singularities associated with the ventricular arrhythmia, a second stage for anti-repinning of the one or more singularities, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities associated delivered via the near-field configuration of the electrodes.

The disclosure relates to a multipolar, detection/stimulation endovascular lead intended to be implanted in the coronary venous network. The lead comprises a lead body with in proximal portion a connector to a cardiac pacemaker/defibrillator generator, and in a distal portion a first branch and a second branch extending beyond a bifurcation. The distal ends of the branches are free ends carrying an array of electrodes connected to the connector. Each of the branches comprises at its free end an outlet in the distal direction, able to receive an implantation guide wire inserted therein and to guide the implantation guide wire in an axial direction parallel to the main axis of the lead body.

In embodiments, a Wearable Cardioverter Defibrillator (WCD) system includes a support structure for the patient to wear, and components that the support structure maintains on the patient's body. The components include a defibrillator, associated electrodes, and so on. The defibrillator can operate in a WCD mode while the patient wears the support structure. The defibrillator can further operate in a different, AED mode, during which time the patient need not wear a portion of the support structure, or even the entire support structure. Sometimes the AED mode is a type of a fully automatic AED mode. Other times the AED mode is a type of a semi-automated AED mode, where an attendant is present to administer the shock; at such times, the patient may not even need to have electrodes attached. This way the patient is more comfortable for a longer time.

Improved devices, circuits and methods of operation in implantable stimulus systems. An implantable defibrillator may comprise an H-bridge output circuit having low and high sides, with a current controlling circuit coupled to the high side of the H-bridge output circuit and a current monitoring circuit coupled to the low side of the H-bridge output circuit. Alternate current paths to the output of the H-bridge, or to the H-Bridge itself, are used for delivering different therapies to the patient.

This disclosure describes implantable medical leads and medical device systems utilizing the leads. In some examples, an implantable medical lead comprises a first defibrillation electrode and a second defibrillation electrode, the first and second defibrillation electrodes configured to deliver anti-tachyarrhythmia shocks, and a pace electrode disposed between the first defibrillation electrode and the second defibrillation electrode, the pace electrode configured to deliver a pacing pulse that generates an electric field proximate to the pace electrode. The implantable medical lead further comprises a shield disposed between the first defibrillation electrode and the second defibrillation electrode and over a portion of an outer surface of the pace electrode, wherein the shield is configured to impede the electric field in a direction from the pace electrode away from a heart.

A wearable therapeutic device is provided. The wearable therapeutic device includes a garment, and the garment includes an electrode and a conductive thread. A control unit is coupled to the conductive thread and identifies an electrical connection between a conductive surface of the electrode and the conductive thread, and an alarm module can provide information about the positioning of the electrode in the garment based on the electrical connection.

In some examples, a medical device system includes an electrode. The medical device system may include impedance measurement circuitry coupled to the electrode, the impedance measurement circuitry may be configured to generate an impedance signal indicating impedance proximate to the electrode. The medical device system may include processing circuitry that may be configured to identify a first component of the impedance signal. The first component of the impedance signal may be correlated to a cardiac event. The processing circuitry may be configured to determine that the cardiac event occurred based on the identification of the first component of the impedance signal.