Livingwithapacemaker.com

Why do I need one?

Your doctor may recommend a pacemaker to make your heart beat more regularly if:

Your heartbeat is too slow and often irregular.
Your heartbeat is sometimes normal and sometimes too fast or too slow.

How does it work?

It replaces the heart's defective natural pacemaker functions.

The sinoatrial (SA) node or sinus node is the heart's natural pacemaker. It's a small mass of specialized cells in the top of the right atrium (upper chamber of the heart). It produces the electrical impulses that cause your heart to beat.
A chamber of the heart contracts when an electrical impulse or signal moves across it. For the heart to beat properly, the signal must travel down a specific path to reach the ventricles (the heart's lower chambers).
When the heart's natural pacemaker is defective, the heartbeat may be too fast, too slow or irregular.
Rhythm problems also can occur because of a blockage of your heart's electrical pathways.
The pacemaker's pulse generator sends electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart.
Most pacemakers have a sensing mode that inhibits the pacemaker from sending impulses when the heartbeat is above a certain level. It allows the pacemaker to fire when the heartbeat is too slow. These are called demand pacemakers.

The invention of the cardiac pacemaker

VA researchers invented the first clinically successful cardiac pacemaker, in 1960. This invention prevents potentially life-threatening complication for irregular heartbeats in many patients.

In 1958, Dr. William Chardack of the Buffalo VA hospital (now the Buffalo VA Medical Center) teamed up with engineer Wilson Greatbatch and Dr. Andrew Gage to implant an electrode in a dog attached to a pulse generator. They worked for the next two years to refine their design of a unit that could be implanted in the body and would maintain the same pulse rhythm for long periods of time.

In 1960, they implanted a pacemaker into a 77-year-old man, who lived for 10 months after the surgery. In that year, they implanted pacemakers into nine other patients, several of whom lived for more than 20 years after the implant. Chardack and Greatbatch's design was the first implanted pacemaker to be commercially produced.

Today, more than 3 million people worldwide have implanted cardiac pacemakers. The VA Pacemaker Program monitors more than 11,000 Veterans with pacemakers to detect battery failures and improve patients' quality of life. The program keeps data on about 60,000 patients.

Principal Investigators: William Chardack, M.D., Wilson Greatbatch, M.S.; Buffalo VA Medical Center

Selected publications:

Chardack WM, Gage AA, Greatbatch W. A transistorized, self-contained, implantable pacemaker for the long-term correction of complete heart block. Surgery. 1960 Oct;48:643-54.

Beck H, Boden WE, Patibandla S, Kireyev D, Gutpa V, Campagna F, Cain ME, Marine JE. 50th anniversary of the first successful permanent pacemaker implantation in the United States: historical review and future directions. Am J Cardiol. 2010 Sep 15;106(6):810-8.

Greatbatch W. The making of the pacemaker. Prometheus Books. 2000.

Patent:

Greatbatch W, inventor. Medical cardiac pacemaker. United States patent US 3,057,356. 1962 Oct 9.

Where we are today

On April 6, the U.S. Food and Drug Administration (FDA) approved the first leadless, transcatheter pacemaker system. The Micra Transcatheter Pacing System from Medtronic, works like other pacemakers to regulate heart rate but is designed to avoid the need for a pacemaker pocket and transvenous lead.

Micra Transcatheter Pacing System from Medtronic

Explore the latest innovations in pacemaker technology.

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