Pacemaker
An artificial cardiac pacemaker (artificial pacemaker, and sometimes just pacemaker, although the term is also used to refer to the body's natural cardiac pacemaker) is a medical device, nowadays always implanted, that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart, the upper atria or lower ventricles. Each pulse causes the targeted chamber(s) to contract and pump blood,[3] thus regulating the function of the electrical conduction system of the heart.
The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a cardiologist to select the optimal pacing modes for individual patients. Most pacemakers are on demand, in which the stimulation of the heart is based on the dynamic demand of the circulatory system. Others send out a fixed rate of impulses.[4]
A specific type of pacemaker called an implantable cardioverter-defibrillator combines pacemaker and defibrillator functions in a single implantable device.[5] Others, called biventricular pacemakers, have multiple electrodes stimulating different positions within the ventricles (the lower heart chambers) to improve their synchronization.[6]
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History
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In 1958, Arne Larsson (1915–2001) became the first to receive an implantable pacemaker. He had 26 devices during his life and campaigned for other patients needing pacemakers.
Origin
In 1889, John Alexander MacWilliam reported in the British Medical Journal (BMJ) of his experiments in which application of an electrical impulse to the human heart in asystole caused a ventricular contraction and that a heart rhythm of 60–70 beats per minute could be evoked by impulses applied at spacings equal to 60–70/minute.[58]
In 1926, Mark C Lidwill of the Royal Prince Alfred Hospital of Sydney, supported by physicist Edgar H. Booth of the University of Sydney, devised a portable apparatus which "plugged into a lighting point" and in which "One pole was applied to a skin pad soaked in strong salt solution" while the other pole "consisted of a needle insulated except at its point, and was plunged into the appropriate cardiac chamber". "The pacemaker rate was variable from about 80 to 120 pulses per minute, and likewise the voltage variable from 1.5 to 120 volts".[59] In 1928, the apparatus was used to revive a stillborn infant at Crown Street Women's Hospital in Sydney, whose heart continued "to beat on its own accord", "at the end of 10 minutes" of stimulation.[60][61]
In 1932, American physiologist Albert Hyman, with the help of his brother, described an electro-mechanical instrument of his own, powered by a spring-wound hand-cranked motor. Hyman himself referred to his invention as an "artificial pacemaker", the term continuing in use to this day.[62][63]
An apparent hiatus in the publication of research conducted between the early 1930s and World War II may be attributed to the public perception of interfering with nature by "reviving the dead".[64] For example, "Hyman did not publish data on the use of his pacemaker in humans because of adverse publicity, both among his fellow physicians, and due to newspaper reporting at the time. Lidwell may have been aware of this and did not proceed with his experiments in humans".[61]
Artificial cardiac pacemaker - Wikipedia
Accidental Inventions as the name suggests refers to the discovery or creation of something new or useful that was not intentionally sought after. From the discovery of penicillin to the creation of the microwave oven, accidental inventions have played a significant role in shaping our world.
In some cases, accidental inventions have even led to entire industries and new fields of research. These inventions often arise from unexpected or accidental circumstances, such as a laboratory mishap or some encounter by chance. While not all accidental inventions may be successful or have significant impact, they serve as a reminder that innovation can come from unexpected sources and that sometimes the most ground-breaking discoveries can be the result of chance. In this Accidental Inventions series of articles we will be telling you about some of the lesser known accidental inventions.
The invention of the Pacemaker is one such case of serendipity!
The pacemaker, a life-saving medical device that regulates the heartbeat of patients with heart diseases, was not invented by design, but rather by accident. The story of its discovery is an interesting tale that highlights the unpredictable nature of scientific exploration.
It all began in the early 1900s when medical researchers began studying the electrical properties of the human body. One of these researchers was Albert Hyman, an American physiologist. In 1932, while conducting an experiment to measure the electrical activity of the heart, Hyman accidentally inserted an electrode too deep into a dog's heart and punctured the heart muscle, causing the heart to stop beating. To his surprise, when he removed the electrode, the heart started beating again. Hyman's accidental discovery led him to speculate that electrical stimulation could be used to regulate the heartbeat in people with heart disease.
However, it took many more years and many more accidental discoveries before the first pacemaker was implanted in a human patient.
In the 1950s, two American doctors, Paul Zoll and William Kouwenhoven, were independently working on developing a device to regulate the heartbeat. Zoll was experimenting with electrical shocks to the heart, while Kouwenhoven was working on a mechanical device that could compress the chest to stimulate the heart.
In 1952, Zoll accidentally discovered that a prolonged electrical shock could cause the heart to beat regularly. This led to the development of a device that could deliver these shocks, and it was used to successfully treat a patient with a dangerously slow heartbeat. Meanwhile, Kouwenhoven's mechanical device was also showing promise, and in 1957, he successfully implanted it in a patient.
The first fully implantable pacemaker was developed by a Swedish engineer, Rune Elmqvist, in 1958. Elmqvist's pacemaker was a small, battery-powered device that could be implanted under the skin and connected to a wire that ran to the heart. Since then, pacemakers have been refined and improved, with today's models being much smaller and more sophisticated. They can be programmed to deliver electrical impulses that are tailored to each patient's needs.
Parallel to Rune, around the same point in time, a young engineer named Wilson Greatbatch was working on a project to develop a device that could record heartbeats. One day, while working on an oscillator that he was building from scratch, Greatbatch accidentally installed the wrong resistor. This caused the oscillator to produce a series of electrical pulses instead of a steady signal.
As he listened to the sound of the electrical pulses, Greatbatch realized that they had a similar rhythm to the human heartbeat. This gave him an idea: what if he used the oscillator to regulate the heartbeat of people with heart conditions?
Over the next few months, Greatbatch worked tirelessly to refine his invention. He added a transistor and a battery to the oscillator, making it small enough to be implanted into the body. He also developed a way to regulate the frequency of the electrical impulses, allowing the device to mimic the natural rhythm of the heart.
In 1960, Greatbatch successfully implanted his pacemaker into a dog, and it worked perfectly. He then tested it on himself, and was amazed at how it regulated his heartbeat. Greatbatch knew he had created something truly remarkable.
He took his invention to several medical device companies, but they were all skeptical of his device. Finally, in 1961, Greatbatch was able to convince a small company called Medtronic to manufacture his pacemaker. The device was approved by the FDA in 1962, and it quickly became a standard treatment for people with heart conditions
Over the years, Greatbatch continued to refine his invention, developing new ways to make the pacemaker smaller, more efficient, and longer-lasting. He received numerous awards and honors for his work, and his invention has saved countless lives.
In conclusion, the accidental invention of the pacemaker by is a testament to the power of serendipity and the importance of curiosity and perseverance in scientific research
In conclusion, the pacemaker is a remarkable medical device that has saved countless lives since its accidental discovery. It serves as a testament to the ingenuity and perseverance of medical researchers who continue to push the boundaries of science and medicine.
Accidental Inventions - Pacemaker - Lexology
Extra Connections:
William Hampson provided William Ramsay with the liquid air that allowed Ramsay to discover neon, krypton, and xenon, for which Ramsay received the Nobel Prize in chemistry of 1904.[12] Hampson also became interested in medical science. He became a licensed apothecary in 1896, and by 1910 he was practising in several London hospitals. In 1912, he published his research on a crude pacemaker.[15] The system electrically stimulated large muscles of the body to contract regularly; pulses of blood were thus forced towards the heart and these pulses would then cause the heart to synchronise with the external electrical stimulator. Hampson also made a minor improvement to X-ray tubes.[16]
Arne Larsson, a patient from Sweden, became the first patient to rely on a synthetic cardiac pacemaker in 1958. He outlived its inventor, the surgeon, and 26 pacemakers before passing away in 2001 at the age of 86.
RK Dewan & Co - Dr Mohan Dewan
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