A subcutaneous cardiac device includes two electrodes and a stimulator
that generates a pulse to the electrodes. The electrodes are implanted
between the skin and the rib cage of the patient and are adapted to
generate an electric field corresponding to the pulse, the electric field
having a substantially uniform voltage gradient as it passes through the
heart. The shapes, sizes, positions and structures of the electrodes are
selected to optimize the voltage gradient of the electric field, and to
minimize the energy dissipated by the electric field outside the heart.
More specifically, the electrodes have contact surfaces that contact the
patient tissues, said contact surfaces having a total contact area of
less than 100 cm.sup.2. In one embodiment, one or both electrodes are
physically separated from the stimulator. In another embodiment a unitary
housing holds the both electrodes and the stimulator. Sensor circuitry
may also includes in the stimulator for detecting intrinsic cardiac
activity through the same electrodes.