CARDIAC PACING VIA THE DISTAL PURKINJE SYSTEM WITH ULTRA-SHORT PULSE WIDTHS

摘要

Methods for cardiac pacing in a human heart using a biphasic waveform having a first pulse having an anodal (positive) polarity followed by a second pulse having a cathodal (negative) polarity. Electrodes in the right bundle branch are used to stimulate the Purkinje fibers with low voltage, ultra-short short pulse widths using a fraction of the energy needed for capture enabling much longer battery life. Alternatively, biphasic anodal/cathodal waveforms are used to stimulate HIS bundle pacing of the mid-septum right bundle branch to enable retrograde conduction back through the atrioventricular (AV) node and down the left bundle thus enabling cardiac resynchronization from the right ventricle. The pacing stimulation applying a biphasic waveform with anodal-first component speeds conduction of pacing stimuli through the conduction system. A sinus node electrode may provide a defibrillation stimulus before the biphasic anodal/cathodal waveforms are applied in HIS bundle pacing.