Method of using a multiple electrode pad assembly

A method of monitoring natural electrical impulses from a patient's heart, and providing appropriate therapeutic electrical impulses to a patient's heart comprising the steps of placing on the patient's chest an electrode pad having a plurality of electrode sites arranged such that at least one electrode site is disposed sufficiently near the patient's right arm to intercept an adequate right arm signal, at least one electrode site is disposed sufficiently near the patient's left arm to intercept an adequate left arm signal, and a plurality of additional electrode sites disposed approximately therebetween. The method also includes the steps of measuring voltage differences between pairs and combinations of the electrode sites for providing ECG signals, monitoring the ECG signals, determining if cardiac pacing is required, determining whether atrial or ventricle pacing is most efficacious and providing pacing signals to the favored electrodes, connecting a proper combination of the remaining electrodes to provide an optimal return path for the pacing signal, providing an appropriate defibrillation current through a first plurality of the electrode sites if the ECG signals indicate defibrillation is required, and coupling a second plurality of electrode sites to provide a return path for the defibrillation current.