Patent EA-003163-B1 (EA)
Title: Augmentation of electrical conduction and contractibility by biphasic cardiac pacing administered via the cardiac blood pool
IPC: A61N1/37
Filed: 1999-01-13
Abstract: 1. A method for electrical cardiac pacing comprising: applying biphasic electrical stimulation to the cardiac blood pool for cardiac pacing, the phases of which have opposite polarities, wherein the first phase polarity is positive. 2. The method for electrical cardiac pacing of claim 1, wherein the first stimulation phase and the second stimulation phase are applied in sequence to the cardiac blood pool. 3. The method for electrical cardiac pacing of claim I, wherein the first phase amplitude is at a maximum subthreshold amplitude. 4. The method for electrical cardiac pacing of claim 3 wherein the maximum subthreshold amplitude is about 0.5 to 3.5 volts. 5. The method for electrical cardiac pacing of claim 1, wherein the first phase duration is at least as long as the second phase duration. 6. The method for electrical cardiac pacing of claim 1, wherein the first phase duration is about one to nine milliseconds. 7. The method for electrical cardiac pacing of claim I, wherein the second phase duration is about 0.2 to 0.9 milliseconds. 8. The method for electrical cardiac pacing of claim 1, wherein the second phase amplitude is about two volts to twenty volts. 9. The method for electrical cardiac pacing of claim 1, wherein the first stimulation phase is initiated greater than 200 milliseconds after completion of a cardiac beating cycle. 10. A method for electrical cardiac pacing comprising: applying biphasic electrical stimulation to the cardiac blood pool for cardiac pacing, the phases of which have opposite polarities, and the first phase amplitude is less than the second phase amplitude. 11. A method for electrical cardiac pacing comprising: applying biphasic electrical stimulation to the cardiac blood pool for cardiac pacing, the phases of which have opposite polarities, wherein the first phase amplitude is ramped from a baseline to a second value. 12. The method for electrical cardiac pacing of claim 11 wherein the second value is equal to the second phase amplitude. 13. The method for electrical cardiac pacing of claim 11 wherein the second value is at a maximum subthreshold amplitude. 14. The method for electrical cardiac pacing of claim 13 wherein the maximum subthreshold amplitude is about 0.5 to 3.5 volts. 15. The method for electrical cardiac pacing of claim 11 wherein the first phase duration is at least as long as the second phase duration. 16. The method for electrical cardiac pacing of claim 11 wherein the first phase duration is about one to nine milliseconds. 17. The method for electrical cardiac pacing of claim 11 wherein the second phase duration is about 0.2 to 0.9 milliseconds. 18. The method for electrical cardiac pacing of claim 11 wherein the second phase amplitude is about two volts to twenty volts. 19. The method for electrical cardiac pacing of claim 11 wherein the second phase duration is less than 0.3 milliseconds and the second phase amplitude is greater than 20 volts. 20. A method for electrical cardiac pacing comprising: applying biphasic electrical stimulation to the cardiac blood pool for cardiac pacing, the phases of which have opposite polarities, wherein the second phase duration is less than 0.3 milliseconds and the second phase amplitude is greater than 20 volts. 21. A method for electrical cardiac pacing comprising: applying biphasic electrical stimulation to the cardiac blood pool for cardiac pacing, the phases of which have opposite polarities, wherein the first stimulation phase further comprises a series of stimulating pulses of a predetermined amplitude, polarity and duration; and wherein the first stimulation phase further comprises a series of stimulating pulses of a predetermined amplitude, polarity and duration; and wherein the first stimulation phase further comprises a series of rest periods. 22. The method for electrical cardiac pacing of claim 21 wherein applying the first stimulation phase further comprises applying a rest period of a baseline amplitude after at least one stimulating pulse. 23. The method for electrical cardiac pacing of claim 22 wherein the rest period is of equal duration to the duration of the stimulating pulse. 24. An apparatus for electrical cardiac pacing, the apparatus comprising a stimulation generator and leads for applying electrical stimulation to a cardiac blood pool, wherein the stimulation generator produces a biphasic electrical waveform to stimulate the cardiac blood pool, the phases of which have opposite polarities, wherein the first phase polarity is positive. 25. The apparatus for electrical cardiac pacing of claim 24, wherein the first stimulation phase and the second stimulation phase are applied in sequence to the cardiac blood pool. 26. The apparatus for electrical cardiac pacing of claim 24, wherein the first phase amplitude is at a maximum subthreshold amplitude. 27. The apparatus for electrical cardiac pacing of claim 26, wherein the maximum subthreshold amplitude is about 0.5 to 3.5 volts. 28. The apparatus for electrical cardiac pacing of claim 24, wherein the first phase duration is at least as long as the second phase duration. 29. The apparatus for electrical cardiac pacing of claim 24, wherein the first phase duration is about one to nine milliseconds. 30. The apparatus for, electrical cardiac pacing of claim 24, wherein the second phase duration is about 0.2 to 0.9 milliseconds. 31. The apparatus for electrical cardiac pacing of claim 24, wherein the second phase amplitude is about two volts to twenty volts. 32. The apparatus for electrical cardiac pacing of claim 24, wherein the first stimulation phase is initiated greater than 200 milliseconds after completion of a cardiac bearing cycle. 33. An apparatus for electrical cardiac pacing, the apparatus comprising a stimulation generator and leads for applying electrical stimulation to a cardiac blood pool, wherein the stimulation generator produces a biphasic electrical waveform to stimulate the cardiac blood pool, the phases of which have opposite polarities, wherein the first phase amplitude is less than the second phase amplitude. 34. The apparatus for electrical cardiac pacing, the apparatus comprising a stimulation generator and leads for applying electrical stimulation to a cardiac blood pool, wherein the stimulation generator produces a biphasic electrical waveform to stimulate the cardiac blood pool, the phases of which have opposite polarities, wherein the first phase amplitude is ramped from a baseline value to a second value. 35. The apparatus for electrical cardiac pacing of claim 34, wherein the second value us equal to the second phase amplitude. 36. The apparatus for electrical cardiac pacing of claim 34, wherein the second value is at a maximum subthreshold amplitude. 37. The apparatus for electrical cardiac pacing of claim 36, wherein the maximum subthreshold amplitude is about 0.5 to 3.5 volts. 38. The apparatus for electrical cardiac pacing of claim 34, wherein the first phase duration is at least as long as the second phase duration. 39. The apparatus for electrical cardiac pacing of claim 34, wherein the first phase duration is about one to nine milliseconds. 40. The apparatus for electrical cardiac pacing of claim 34, wherein the second phase duration is about 0.2 to 0.9 milliseconds. 41. The apparatus for electrical cardiac pacing of claim 34, wherein the second phase amplitude is about two volts to twenty volts. 42. The apparatus for electrical cardiac pacing of claim 34, wherein the second phase duration is less than 0.3 milliseconds and the second phase amplitude is greater than 20 volts. 43. An apparatus for electrical cardiac pacing, the apparatus comprising a stimulation generator and leads for applying electrical stimulation to a cardiac blood pool, wherein the stimulation generator produces a biphasic electrical waveform to stimulate the cardiac blood pool, the phases of which have opposite polarities, wherein the second phase duration is less than 0.3 milliseconds and the second phase amplitude is greater than 20 volts. 44. The apparatus for electrical cardiac pacing, the apparatus comprising a stimulation generator and leads for applying electrical stimulation to a cardiac blood pool, wherein the stimulation generator produces a biphasic electrical waveform to stimulate the cardiac blood pool, the phases of which have opposite polarities, wherein the first stimulation phase further comprises a series of stimulating pulses of a predetermined amplitude, polarity and duration and wherein the first stimulation phase further comprises a series of rest periods. 45. The apparatus for electrical cardiac pacing of claim 44, wherein applying the first stimulation phase further comprises applying a rest period of a baseline amplitude after at least one stimulating pulse. 46. The apparatus for electrical cardiac pacing of claim 45, wherein the rest period is of equal duration to the duration of the stimulating pulse.