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Diverse techniques have been developed for controlling the cardiac rate by external means when normal physiological processes fail to maintain a stable rate. These techniques are presented in a brief summary. The factors underlying the choice of the radio-frequency transmission technique are presented and evaluated, taking into account control of the stimulus, avoidance of infection, and minimizing the number of electrical components within the body. A set of design specifications is then evolved based upon the physiological needs of the patient, utilizing the philosophy of the RF transmission approach. The design of two transistorized, battery-operated pacemakers is then presented in detail with a description of the constructed units and an evaluation of performance. These units have now been used successfully on five patients.