the fig . ( 2 ) to fig . ( 6 ) clearly explains the technique used to stimulate the myocardium the heart muscle using two high frequency currents . by varying the phase or pulse width modulating one carrier a resultant pulse produced at the target area is one similar to a internal pacemaker waveshape is achieved . this technique of stimulation overcomes all serious disadvantages of prior art . also user can adjust the stimulation area to get the desired effect . the general operation of the preferred embodiment of the present invention is illustrated in fig . ( 4 ). this differs from the prior art of ntp that it requires four conducting electrodes along with high frequency currents as shown . the set of electrodes 1 a and 1 b constitute one circuit and similarly 2 a and 2 b constitute another isolated circuit . when high frequency currents are passed , the currents heterodyne at the intersection point and resultant beat impulse is produced in the target area ( 4 ). fig . ( 4 ) explicitly explains how cardiac stimulation can be achieved by using interferential technique . the location of the pads and its usefulness to select an area of stimulation is described in fig . ( 5 ). by moving set of opposite electrodes 1 a & amp ; 1 b , one can achieve any target area stimulation . may be atrium or ventricle can be targeted . this feature will be helpful to improve the cardiac output by an experienced physician by properly stimulating the atrium or ventricle . placement of electrodes is the key to the selection of area in the myocardium . figs . ( 2 a ) and 2 ( b ) explains the basic working of interferential currents . fig2 ( a ) illustrates how two channels of isolated high frequency currents when crosses it heterodyne and produces beating frequency . in fig . ( 2 b ) illustrates how out of phase pulsed high frequency produces the gated pulses . this explains the basic principle behind the myocardium stimulation by using high frequency . fig . ( 3 ) illustrates how the actual interferential current from two channels from properly positioned electrodes produces stimulation in the intersection path area ( 3 ). fig . ( 1 ) illustrates how in prior art the electrodes are positioned . fig . ( 6 ) illustrates the method of electrode placement for interferential pacing . depending on the area of myocardial stimulation the electrode placements will vary from one end to another in the thorax . there is numerable ways of electrode placement possible to achieve different effects . meanwhile the fig6 ( a ) illustrates using integrated 2 electrodes like prior art but the one piece of electrode will contain two circuits as shown and with two electrodes two circuits are established to produce interferential currents . this may be easily achievable by using 4 separate electrodes as shown in fig6 ( b ). with fig6 ( b ) scheme one can adjust and attain stimulation precisely at different parts of myocardium . fig . ( 1 ) illustrates the prior art of non invasive temporary pacing using two big electrodes . two methods of electrode placement is popular as shown in fig1 ( a ) anterior / lateral placement and fig1 ( b ) anterior / posterior placement . while the preferred embodiments of the invention has been illustrated and described , it will be apparent that various changes can be made therein without departing from the sprit and scope of the invention . for example , the fig . ( 5 ) electrode positioning is shown in one axis whereas electrode movement can be made in another axis . also the movement itself be made using an automatic tool . consequently , within the scope of the appended claims , it will be appreciated that the invention can be practiced otherwise than as specifically described herein . fig . ( 7 ) illustrates the block diagram of interferential noninvasive pacing device . the cpu ( 5 ) is the master of the device . it is functionally responsible for the acquisition and processing of ecg , displaying of ecg , generating time base for the two channels , controlling the modes of pacing and strength of pacing currents . a microcontroller with inbuilt program memory , ram , timer and i / o ports is used . the adc ( 6 ) digitize the processed ecg signal fed by programmable gain amplifier ( 7 ). the programmable gain amplifier is controlled by the cpu for the gain . the input ecg amplifier ( 8 ) consists of pre and post amplifiers . the pre amplifier is fully electrically isolated for the patient safety . the ecg and pacing pulse is displayed as two traces . ecg trace is displayed above and the pace stimulation pulse is displayed as second trace below . this allows the user to instantly compare the two traces and conclude the cardiac capture due to non invasive stimulation . the display is of graphic lcd / tft screen ( 9 ) sufficient enough to display two traces . the cpu ( 5 ) directly writes in to graphic display and maintains the display content . also the keyboard ( 10 ) is interfaced to cpu ( 5 ). user can program the stimulus frequency , its current strength etc ., using this keyboard . also the cpu ( 2 ) is connected to heart of the pacer consisting of two channels viz ., channel 1 ( 11 ) and channel 2 ( 12 ). each channel is programmed to base frequency of say 4000 hz and either one of them can be phase or frequency shifted by the cpu ( 5 ) as per the user program programmed earlier . the identical high frequency signals are getting amplified by the respective power amplifiers ( 13 ) and ( 14 ). the power amplifier is coupled with transformer isolator that the output current is fully isolated and independent . the current strength is varied by the cpu ( 5 ) directly by using an current controller ( 15 ) which biases the power amplifier to deliver the programmed out put current . depending on the setting of the pace frequency the cpu ( 5 ) outputs high frequency pulsed currents via two channels . but the waveforms of the channel are modulated in such a way that the beat frequency process the stimulus pulse at the target area . in this preferred embodiment it will be appreciated that the both channels are closely controlled by the cpu and the output current is isolated electrically by means of magnetic isolation . also it will be appreciated that the pacer can be put into asynchronous mode or in demand mode . again the outputting beat frequency is software controlled accordingly to the mode set by the user . power supply section ( 16 ) is an dc - dc converter with battery charger . it supplies all the power requirements of blocks . it also charges the battery whenever the mains power is connected and present . the mains power is converted into dc by smps ( 17 ). while the preferred embodiments of the invention has been illustrated and described , it will be apparent that various changes can be made therein without departing from the sprit and scope of the invention . for example , the generation of the bi - phasic high frequency currents can be devised by many means . consequently , within the scope of the appended claims , it will be appreciated that the invention can be practiced otherwise than as specifically described herein .
new effective emergency non invasive pacing technique and apparatus is designed to improve the heart rate , cardiac output in patients during bradycardia . it also overcomes the existing disadvantages of unwanted transcutaneous muscular stimulation in the process of cardiac stimulation . this method uses interferential high frequency currents to selectively produce pulsed stimulus to the desirable area of myocardium is introduced .