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Techniques & Technologies

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Pacemaker

X-ray showing a pacemaker.

X-ray showing a pacemaker.

Credits:Wellcome Library, London

Pacemakers use electrical impulses to regulate the beating of the heart. They treat disorders making the heart’s rhythm too slow, fast or irregular. Abnormal heart rhythms are called arrhythmias.

Electrical activity within the heart was discovered during the 1800s. However, devices for artificially controlling the heart’s rate were not devised until the 20th century.

In 1932, American physiologist Albert Hyman built the first device called an ‘artificial pacemaker’. It was powered by a hand-cranked motor. Hyman tested his pacemaker on animals, and never published any results of using his pacemaker on humans. During the 1930s artificial heart stimulation was controversial and likened to reviving the dead.

After the Second World War innovators such as Paul Zoll and Earl Bakken pioneered smaller pacemakers. Some of these were worn like a necklace. In 1958 the first pacemaker to be implanted was given to Arne Larsson in Sweden. The device failed after three hours. A second device lasted two days.

Implanting electronic devices into the body presented problems. Electronic components were too bulky until the development of silicon transistors in 1956. Early pacemaker batteries had short, unreliable lifetimes until Wilson Greatbatch pioneered long-life lithium batteries in the 1970s. Another problem was preventing water in the body affecting the pacemaker’s electronics. This was solved by using hermetically sealed titanium cases. Pacemakers are now the size of a large coin and are implanted near the heart.

Bibliography

W Greatbatch, The making of the pacemaker: celebrating a lifesaving invention (New York: Prometheus Books, 2000)

H J Thalen et al, The artificial cardiac pacemaker: its history, development and clinical application (Assen: Van Gorcum; 1969)

A Gage, ‘The development of the implantable cardiac pacemaker’, in L Sentz (ed.), Medical history in Buffalo, 1846-1996: collected essays (Buffalo: Friends of the Health Science Library and School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 1996)

J Kirk, ‘Pacing the heart: growth and redefinition of a medical technology, 1952-1975’, Technology and culture, (36, 1995), pp 583-624

J Kirk, Machines in our hearts: the cardiac pacemaker, the implantable defibrillator, and American health care (Baltimore London: Johns Hopkins University Press, 2001)

Glossary:

Physiology

The science of the functioning of living organisms and their component parts.

Physiology

The science of the functioning of living organisms and their component parts.

Hermetic

A completely closed and airtight seal.