Patent ID: 8473051

Claim:
An atrial arrhythmia treatment apparatus, comprising: at least one electrode adapted to be implanted proximate an atrium of a heart of a patient to deliver pulses; at least one electrode adapted to be implanted proximate the atrium of the heart of the patient to deliver near field pulses and sense cardiac signals; an implantable therapy generator adapted to be implanted in a patient and operably connected to the electrodes, including: sensing circuitry that senses cardiac signals representative of atrial activity and ventricular activity; detection circuitry operably connected to the sensing circuitry to evaluate the cardiac signals representative of atrial activity to determine an atrial cycle length and detect an atrial arrhythmia based at least in part on the atrial cycle length; control circuitry operably connected to the sensing circuitry that, in response to the atrial arrhythmia, controls generation and selective delivery of a multi-stage atrial cardioversion therapy to the electrodes, each stage comprising a plurality of pulses, each pulse comprising a plurality of high-frequency sub-pulses; and therapy circuitry operably connected to the electrodes and the control circuitry including: a high-voltage charging circuit in electrical connection with a storage capacitor, the high-voltage charging circuit adapted to charge the storage capacitor to a predetermined voltage; a delivery capacitor connectable to the storage capacitor and to the at least one electrode adapted to be implanted proximate the atrium of the heart; a control circuit adapted to selectively cause the storage capacitor to be electrically connected to the delivery capacitor so as to charge the delivery capacitor to a predetermined delivery voltage, and to cause a delivery switching circuit to be repeatedly opened and closed at a predetermined rate, thereby electrically connecting and disconnecting the delivery capacitor to the at least one electrode to be implanted proximate the atrium of the heart such that multiple electrical sub-pulse shocks are transmitted to the at least one electrode to be implanted proximate the atrium of the heart.