In one embodiment, a wearable cardioverter defibrillator (WCD) is described. The WCD includes a support structure worn by a patient. A processor is coupled to the support structure. The WCD also includes a discharge circuit coupled to an energy storage module, the discharge circuit configured to discharge the stored electrical charge through a body of the patient. The wearable cardioverter defibrillator also includes a user interface housing at least one sensor and responsive to changes in device orientation. The processor is configured to detect a motion at the user interface and determine when the motion is patient-activated. When the motion is patient-activated, the processor determines a direction of rotation. The processor determines an orientation of a display at the user interface based on the direction of rotation and orients the display at the user interface to appear upright to the patient.

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 novel therapeutic biphasic or multiphasic pulse waveform and method are provided. The novel therapeutic biphasic or multiphasic pulse waveform may be used in a defibrillator, or in another medical device that delivers therapeutic electrical stimulation pulses to a patient.

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.

Improved devices, circuits and methods of operation in implantable stimulus systems. An implantable defibrillator may comprise a charging circuit using a transformer to store and build up energy on an HV capacitor or capacitor stack, with the HV capacitor in turn coupled to an H-bridge output circuit having low and high sides for issuing therapy. In the output current path, a current controlling circuitry is placed between the H-bridge and ground, allowing the greater flexibility in the selection of switching devices, and drivers for such devices, in the H-bridge circuit and/or enabling circuits between the H-bridge and the HV capacitor or other therapy circuit.

A pulse generation system is disclosed. The pulse generation system includes a controller, an output terminal, and a plurality of pulse generator circuits. The controller is configured to cause a driving signal pulse to be transmitted to any selected one or more of the pulse generator circuits, and to cause the driving signal pulse to not be transmitted to any selected one or more other pulse generator circuits. Each of the pulse generator circuits is configured to generate an output voltage pulse at the output terminal in response to the driving signal pulse being transmitted thereto.

Defibrillator shock discharge control systems and schemes are described that control the shock discharge based at least in part on discharge capacitor voltage measurement taken after the defibrillation shock has been initiated.

A pulse generation system is disclosed. The pulse generation system includes a controller, an output terminal, and a plurality of pulse generator circuits. The controller is configured to cause a driving signal pulse to be transmitted to any selected one or more of the pulse generator circuits, and to cause the driving signal pulse to not be transmitted to any selected one or more other pulse generator circuits. Each of the pulse generator circuits is configured to generate an output voltage pulse at the output terminal in response to the driving signal pulse being transmitted thereto.

A system to deliver therapeutic energy to a patient, the system including a storage capacitor configured to store and release the therapeutic energy, a boost converter circuit coupled to the storage capacitor, and a current flow control circuit coupled to the boost converter circuit and including a plurality of control circuits configured to control a current output from the current flow control circuit in a therapeutic biphasic voltage waveform upon release of the therapeutic energy from the storage capacitor, wherein the therapeutic biphasic voltage waveform includes a ramped increase in voltage from approximately zero volts to a desired therapeutic voltage level over a time interval greater than 1 millisecond and less than a time associated with a phase switch.

A dynamically adjustable multiphasic pulse system and method are provided. The dynamically adjustable multiphasic pulse system may be used as pulse system for a defibrillator or cardioverter.