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History of Cardiac Pacing

  • Srijoy Mahapatra

In 1954 Dr. C. Walton Lillehei, a cardiac surgeon at the University of Minnesota, made advances in the treatment of the blue baby syndrome. In blue baby syndrome there is an abnormal blood communication between the left and right chambers of the heart. As a part of the treatment, Lillehei typically closed holes in the septum between the left and right heart chambers. Because the normal conduction system is in this septum, one common complication of the surgery was complete heart blockage, which meant the patient had no pulse. This heart blockage often resolved over a period of weeks, but to keep the child alive until then, Lillehei used temporary epicardial pacing. These pacing pads were sewn onto the heart and power by a large cart-mounted electrical generator. The patients were effectively tethered to the wall plug. If nurses had to move them, the staff could walk only so far as the next electrical outlet, unplug the generator, and then replug it into the next outlet. This not only made it difficult for the patients to be active, it made it difficult to move them for tests. This system, while cumbersome, allowed Lillehei to keep many children alive, and by 1957 he was one of the busiest congenital cardiac surgeons in the nation.

On October 31, 1957, a 3-hour power outage in Minneapolis rendered these generators useless because the wards had no backup electrical generators. Although one version of the story is that a child died, in an interview with Earl Bakken, Lillehei reported no deaths. Nonetheless, Lillehei knew he needed something battery operated.1 Soon after this, Lillehei contacted Bakken, an engineer who owned the Medtronic medical equipment service company. Bakken spent the next month working on a pacemaker generator that would be small enough to wear and be powered by batteries. As inspiration he used an electronic, transistor-based metronome that generated sound periodically.

Keywords

Right Ventricle Right Atrium Complete Heart Block Cardiac Pace Sinus Node Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Jefferey K. Machines in Our Hearts. Baltimore: JHU; 2001:68Google Scholar
  2. 2.
    Luderitz B. History of the Disorders of Cardiac Rhythm. Armonk: Futura Publishing 2002:4Google Scholar
  3. 3.
    Cheng TO. Decreased heart rate variability as a predictor for sudden death was know in China in the third century AD. Eur Heart J 2000;21:2081–2082PubMedCrossRefGoogle Scholar
  4. 4.
    Cowan MJ. Measurement of heart rate variability. Western Journal of Nursing Researc 1995;17:32–48CrossRefGoogle Scholar
  5. 5.
    Luderitz B. History of the Disorders of Cardiac Rhythm. Armonk: Futura Publishing 2002:27Google Scholar
  6. 6.
    Adams R. (1791–1875) Morgagni—Adams–Stokes syndrome. JAMA 1968;206:639–640Google Scholar
  7. 7.
    Galvani L. Commentary on the Effects of Electricity on Muscular Motion. Trans. b Foley MG. Norwalk: Burdy Libarary; 1953Google Scholar
  8. 8.
    Wikipedia Search Lugi Galvani on Aug 11, 2007Google Scholar
  9. 9.
    Gedes LA, Bakken E. IEEE Engineering in Medicine and Biology 2007;26:77–79Google Scholar
  10. 10.
    Luderitz B. History of the Disorders of Cardiac Rhythm. Armonk: Futura Publishing 2002:68Google Scholar
  11. 11.
    Luderitz B. History of the Disorders of Cardiac Rhythm. Armonk: Futura Publishing 2002:120Google Scholar
  12. 12.
    Marmorstein M. Contribution of l'etude des excitation electriques localisees sur le Coeur en rapport avec la topographie de l'innervation de coeur chez le chien. J Physiol (Paris)1927;25:617Google Scholar
  13. 13.
    Luderitz B. History of the Disorders of Cardiac Rhythm. Armonk: Futura Publishing;2002:125Google Scholar
  14. 14.
    Hyman AS. Resuscitation of the stopped heart by intracardial therapy, II: experimental use of an artificial pacemaker. Arch Int Med 1932;50:283–305Google Scholar
  15. 15.
    Callaghan JC, Bigelow W. An electrical artificial pacemaker for standstill of the heart.Ann Surg 1951;134:8–17Google Scholar
  16. 16.
    Jefferey K. Machines in Our Hearts. Baltimore: JHU; 2001:90Google Scholar
  17. 17.
    Jefferey K. Machines in Our Hearts. Baltimore: JHU; 2001:123Google Scholar
  18. 18.
    Parsonnet V, Littleford P. PAC E 1981;1:109–112Google Scholar
  19. 19.
    Silver AW. Annals Thoraic Surgery 1:380–388Google Scholar
  20. 20.
    Jeffery K. Machines in Our Hearts. Baltimore: JHU; 2001:138Google Scholar
  21. 21.
    Furman S. Therapeutic uses of atrial pacing. Am Heart J 1973;73:835–840CrossRefGoogle Scholar
  22. 22.
    Castillo C. Bifocal demand pacing. Chest 1971;59:360–364CrossRefGoogle Scholar
  23. 23.
    Belott PH. A variation on the introducer technique for unlimited access to the subclavian vein. PAC E 1981;4:43–48Google Scholar
  24. 24.
    Kastor JA. Michel Mirowski and the automatic implantable defibrillator. Am J Cardiol 1989;63:977–982 and 1121–1126PubMedCrossRefGoogle Scholar
  25. 25.
    Jefferey K. Machines in Our Hearts. Baltimore: JHU; 2001:239Google Scholar

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Srijoy Mahapatra
    • 1
  1. 1.Division of Cardiovascular MedicineUniversity of VirginiaCharlottesvilleUSA

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