Implantable cardioverter

Abstract

A body implantable ventricular cardioverting system. Circuitry is provided which detects the onset of a malignant ventricular tachyarrhythmia and provides a cardioverting signal in response thereto. The cardioverting signal has an energy level that is high relative to the pacing threshhold but below that necessary for defibrillation. In this manner, a ventricular tachyarrhythmia can be cardioverted before the onset of fibrillation and at a lower energy than required for defibrillation. Dependent on such factors as patient threshholds, the tissue/electrode interface and the electrode system employed, the energy level of the cardioverting signal is from 5 millijoules to 15 joules. The system can be configured such that increasingly malignant tachyarrhythmias result in higher energy cardioverting signals, including signals capable of defibrillation. Successful cardioversion with a signal having an energy level lower than necessary for defibrillation reduces the physical damage to the heart as well as the trauma to and discomfort of the patient.