Biologic Pacemakers: Past, Present, and Future

Abstract

Cardiac pacemakers are one of the most important medical innovations of our era. The term, pacemaker, was coined by Albert Hymen, who described in 1932 an electromechanical instrument, powered by a spring-wound hand-cranked motor, which could provide electric shocks. In 1952, Paul Zoll developed transcutaneous pacing devices using large rechargeable batteries as power supplies. In 1957, engineer Earl Bakken, the founder of Medtronic, produced the first wearable external pacemaker for a patient of Dr C. Walton Lillehei. The transistorized pacemaker, housed in a small plastic box, had controls to permit adjustment of pacing rate and output voltage and was connected to electrodes leads that passed through the skin of a patient to terminate in electrodes attached to the surface of the myocardium. In 1958, transvenous endocardial pacing was first demonstrated by Seymour Furman, during which a catheter electrode was inserted via a patient’s basilic vein. The first clinical implantation into a human of a fully implantable pacemaker took place in October 1958 at the Karolinska