Cardiac pacing

Abstract

A cardiac pacing system that includes an implantable pulse generator and electrical leads that include a lead body portion having a distal end and a proximal end, a connector configured to electrically connect the proximal end of the lead body to the pulse generator, and at least one electrode disposed at the distal end of the lead body for delivering electrical stimulation to a patient's heart, wherein the distal end of the lead body is configured to terminate within the mediastinum of the thoracic cavity of the patient, proximate to the heart.

What is claimed is: 
     
         1 . A system comprising:
 a pulse generator comprising:
 an atrial pulse generator configured to generate electrical pulses for delivery to one or more atria; 
 a ventricular pulse generator configured to generate electrical pulses for delivery to one or more ventricles; and 
 a controller configured to cause the atrial pulse generator and/or the ventricular pulse generator to generate the electrical pulses based on a therapy protocol. 
   
     
     
         2 . The system of  claim 1 , the controller further configured to control the atrial pulse generator and/or the ventricular pulse generator to deliver electrical pulses having amplitude, pulse width, frequency, or electrode polarities based on the therapy protocol. 
     
     
         3 . The system of  claim 1 , wherein the pulse generator includes one or more sensors and is configured to:
 sense and discriminate atrial and ventricular activity based on processing one or more sensed signals;   detect a cardiac condition based on processing the discriminated atrial and ventricular activity; and   determine appropriate electrical stimuli for the therapy protocol to be delivered to the heart of a patient with the generated electrical pulses.   
     
     
         4 . The system of  claim 3 , wherein the cardiac condition comprises one or more of dyssynrony, bradycardia, or tachycardia. 
     
     
         5 . The system of  claim 1 , further comprising a ventricular pulsing lead and an atrial pulsing lead, the ventricular pulsing lead and the atrial pulsing lead coupled to the pulse generator to transmit the electrical pulses. 
     
     
         6 . The system of  claim 5 , further comprising a sensor on the atrial pulsing lead and a sensor on the ventricular pulsing lead to sense and discriminate atrial and ventricular activity, the controller further configured to cause electrical stimulation to be transmitted through the atrial pulsing lead and the ventricular pulsing lead. 
     
     
         7 . The system of  claim 5 , the pulse generator further comprising one or more capacitors, the controller configured to discharge the one or more capacitors through the ventricular pulsing lead and/or atrial pulsing lead based on the therapy protocol. 
     
     
         8 . The system of  claim 7 , further comprising a battery, wherein the one or more capacitors are charged by the battery. 
     
     
         9 . The system of  claim 1 , wherein the pulse generator is configured to utilize a plurality of electrodes and the controller is configured to alter sensing and/or delivery vectors between available electrodes to enhance detection of a cardiac condition and/or improve an efficacy of a therapy delivered utilizing the electrical pulses.