Hyman pacemaker (reproduction)

Operated by a hand crank, spring motor and magneto, the machine would produce electricity to be introduced into the heart by plunging a needle through the chest wall, causing the heart to beat.

Photo courtesy of North American Society of Pacing and Electrophysiology.

© CHIN 2001


The development of the artificial pacemaker began in the early 20th century. In France, M. Marmorstein first stimulated the sinoatrial node and the right and left ventricles in dogs in 1927. An Australian physician, Mark Lidwill, along with physicist Edgar Booth, built a portable pacemaking unit in 1931.

At the same time, Albert Hyman in New York was developing a similar device. In 1932, Hyman resuscitated several patients using periodic voltage impulses. He called his device an artificial pacemaker, the name in common use today.

Another milestone was reached in 1950 when Wilfred Bigelow and John Callaghan from the University of Toronto, and John Hopps of the National Research Council jointly published their work on heart stimulation in animals.

In 1952, Paul Zoll, a cardiologist in Boston, made the first practical external pacemaker. He used the basic circuitry from the NRC machine, but instead of having the electrodes attached to the heart itself, the electrodes were attached to the chest of the patient. He treated two patients with this device, but it wasn’t suitable for long-term use because it could only be used while the patient was h Read More
The development of the artificial pacemaker began in the early 20th century. In France, M. Marmorstein first stimulated the sinoatrial node and the right and left ventricles in dogs in 1927. An Australian physician, Mark Lidwill, along with physicist Edgar Booth, built a portable pacemaking unit in 1931.

At the same time, Albert Hyman in New York was developing a similar device. In 1932, Hyman resuscitated several patients using periodic voltage impulses. He called his device an artificial pacemaker, the name in common use today.

Another milestone was reached in 1950 when Wilfred Bigelow and John Callaghan from the University of Toronto, and John Hopps of the National Research Council jointly published their work on heart stimulation in animals.

In 1952, Paul Zoll, a cardiologist in Boston, made the first practical external pacemaker. He used the basic circuitry from the NRC machine, but instead of having the electrodes attached to the heart itself, the electrodes were attached to the chest of the patient. He treated two patients with this device, but it wasn’t suitable for long-term use because it could only be used while the patient was hospitalized and confined to bed. Further, electric shocks to the skin of the chest involved a considerable amount of discomfort.

Transvenous catheter pacing was introduced by S. Furman in 1958. Transvenous pacing, in which the electrode is passed down a vein to the interior of the heart, permitted the development of intracardiac diagnosis of arrythmias. This was an important step towards the implantable pacemaker.

In 1957, Earl Bakken, at the request of an American heart surgeon, Walton Lillehei, developed the first wearable transistorized pacemaker. This pacemaker was a prototype, and intended only for laboratory use; Dr. Lillehei liked it so much he used it on a number of patients.

In 1958, prompted by Swedish doctor Åke Sennings, Rune Elmqvist designed the first rechargeable, implantable pacemaker. Dr. Senning implanted myocardial electrodes and a pulse generator with a rechargeable nickel-cadmium battery in a 40-year old patient.

© CHIN 2001

Bigelow pacemaker

First artificial pacemaker using intravenous catheters to deliver stimulus to the sino-auricular node and capable of starting stopped hearts and controlling irregular heart rates.

Radio and Electric Laboratories, NRC, Ottawa, and Toronto General Hospital, Toronto
University Health Network Artifact Collection
c. 1951
1994.1.28
© CHIN 2001


Zoll pacemaker

A patient with a Zoll pacemaker in place, allowing for stimulation of the heart across the closed chest.

Photo courtesy of North American Society of Pacing and Electrophysiology.

© CHIN 2001


Bakken external pacemaker

This prototype wearable pacemaker was a significant step in the evolution to fully implantable units.

Photo courtesy of Bakken Library and Museum, Minneapolis, USA.

© CHIN 2001


Elmqvist internal pacemaker

The first pacemaker to be implanted under the skin, 1959.

Photo courtesy of University Health Network Artifact Collection.

© CHIN 2001


The "natural" pacemaker of the heart is called the sinoatrial (S.A.) node or sinus node. It is a small mass of specialized cells in the top of the right atrium or chamber of the heart. It produces the electrical impulses that cause your heart to beat.

The natural pacemaker may be defective, causing the heartbeat to be too fast, too slow or irregularly. There may also be a blockage of the heart’s electrical pathways. When this system ceases to work properly, the solution may be a pacemaker.

The pacemaker has two parts--the pulse generator, which produces the pacing impulses, and the lead or leads, which deliver these impulses to the heart. The silver-dollar-size generator, which has an effective life of seven to twelve years, is implanted just beneath the skin below the collarbone. The leads are threaded into position through veins leading back to the heart. By reading these signals, the pulse generator is able to monitor the heart’s activity and respond appropriately. The entire implantation procedure requires only a local anaesthetic, and takes about an hour.
The "natural" pacemaker of the heart is called the sinoatrial (S.A.) node or sinus node. It is a small mass of specialized cells in the top of the right atrium or chamber of the heart. It produces the electrical impulses that cause your heart to beat.

The natural pacemaker may be defective, causing the heartbeat to be too fast, too slow or irregularly. There may also be a blockage of the heart’s electrical pathways. When this system ceases to work properly, the solution may be a pacemaker.

The pacemaker has two parts--the pulse generator, which produces the pacing impulses, and the lead or leads, which deliver these impulses to the heart. The silver-dollar-size generator, which has an effective life of seven to twelve years, is implanted just beneath the skin below the collarbone. The leads are threaded into position through veins leading back to the heart. By reading these signals, the pulse generator is able to monitor the heart’s activity and respond appropriately. The entire implantation procedure requires only a local anaesthetic, and takes about an hour.

© CHIN 2001

How the heart works

The heart is stimulated by nodal tissue, which is composed of specialized muscle cells. This tissue is found in the sinoatrial (SA) node and the atrioventricular (AV) node, both located in the right atrium. In the SA node, the electric impulses are generated for cardiac contraction (70-80 beats a minute). These impulses pass to and stimulate the AV node. This stimulation is propagated to the two ventricles through the bundle of His and the Purkinje fibres.

Photo courtesy of Parramon Ediciones, Spain
© CHIN 2001

© 2008, CHIN. All Rights Reserved.


Implantation of a pacemaker

Illustration of a transvenous implantation of a ventricular pacemaker.

Photo courtesy of CIBA

© CHIN 2001


Learning Objectives

The learner will:

  • Identify and appreciate the way history and culture shape a society’s science and technology
  • Provide examples of how science and technology have influenced the diagnosis and treatment of human illness, and have made medical technology an integral part of our lives
  • Describe scientific and technological developments, past and present, and appreciate their impact on individuals and societies
  • Describe how Canadians have contributed to science and technology on the global stage

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