| 摘要 |
A medical interventional device (13) is structured for implantation in a human patient (10), to respond to detection of cardiac dysrhythmias. Dysrhythmias in either the atrial or ventricular chambers (24, 29) are automatically treated by a selected therapy regimen consisting of pacing, cardioverting or defibrillating waveforms of predetermined type and energy content to the chamber diagnosed as that in which the dysrhythmia originated. The device incorporates a DDD or DDD-R pacemaker (not numbered) for dual chamber sensing of electrical (ECG) activity, and for constant atrioventricular synchronization. A microprocessor-based logic subsystem (not numbered) diagnoses the origin of a rhythm disorder and identifies the originating heart chamber. The electrode system (21, 26, 42, 38) for delivering the selected therapy includes a single lead (22, 27) for pacing, sensing, cardioversion and defibrillation associated with each of the right atrial and ventricular chambers (24, 29). The device's metal case (15) may be used as the defibrillator's counter-electrode. A cardiac electrode (42) implanted in the distal coronary sinus improves defibrillation and left heart stimulation for better hemodynamic response. Dual chamber rate responsive pacing further improves hemodynamics.
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