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Abstract

Disclosed are an electrode configuration and a method for its use with an automatic implantable cardioverter/defibrillator. The electrode configuration includes a catheter electrode intravenously positioned within the heart of a patient wherein one electrode, defined by the catheter, is within the right ventricle and a second electrode, also defined by the catheter and spaced from the first electrode, is within the superior vena cava region. A third electrode, in the form of a flexible, substantially planar patch, is subcutaneously positioned outside the thoracic cavity in the region of the left ventricle. At the time of electrical discharge, or permanently, the first and second electrodes of the catheter are connected together. The electrode arrangement can be implanted without opening of the thoracic cavity by intravenously placing the catheter electrode within the heart of a patient and subcutaneously implanting the patch electrode between the skin and the thoracic cavity. The automatic implantable cardioverter/defibrillator senses life-threatening arrhythmic conditions of the heart and issues at least one cardioverting or defibrillating pulse that is applied between the electrode positioned in the region of the left ventricle and the commonly connected catheter electrodes positioned, respectively, in the right ventricle and within the superior vena cava region. The catheter also includes a pacing tip.

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