The First Pacemaker Implant in America

‘A pacemaker in my heart’– classification of questions asked by pacemaker patients as a basis for intervention

“…Heart pacemaker implanting started 50 years ago (Fiandra 1988). Initially the procedure involved chest opening (thoracotomy) and placement of electrodes externally on the heart.…”

“…Since then, the unipolar pacemaker (containing a single electrode) was used, pacing the heart at a constant rate, defined in advance. This primary pacemaker had many disadvantages; the rate which was set in advance was not synchronised with the changes in heart activity (VOO), the device was large and cumbersome and its batteries lasted less than one year (Fiandra 1988). In 1965, Limberd designed a unichamber‐ventricle pacemaker.…”

“…Since the 1980s, sophisticated ‘physiological’ pacemakers, with two chambers (consisting of one electrode in each – ventricle and atrium), were developed, enabling ventricle‐atrium coordination. The rate‐response quality, characterising the new generation of pacemakers, adjusted rating speed with patient’s metabolic need, thus enabled a faster rate during physical exercise, while maintaining heart output (Fiandra 1988, Fye 2002).…”

Lessons From the First Patient with an Implanted Pacemaker:

“…Elema Schönander began manufacture of pulse generators on a small scale and the Elema 135 rechargeable pacemaker was reported to have been successfully implanted in Stockholm 1959, 6 in Uruguay February 1960, 11 and in England March 1960 12 . At that time cardiac diagnostics were not advanced and the prevalence and clinical implications of intermittent bradycardia was not well established.…”

Development of Implantable Medical Devices: From an Engineering Perspective

“…The electrical-pulse-generating system was connected with electrodes via stainless steel wire covered with polyethylene. The total size of the first implantable pacemaker was 55 mm in diameter and 16 mm in thickness, similar to the dimensions of a shoe polish can from British Kiwi [10]. …”