Re: Who is the first inventor of pacemaker and when?

Dear Genevieve:

A very interesting question.  It’s not so much a matter of controversy over who invented 
the pacemaker as it is over the evolving nature of its development.

Hyman in 1932 first used artificial electrical impulses to pace the heart in animals [1].  
He used a transthoracic needle as the electrode which was connected to an external 
generator.  Evidently he was met with some resistance from the scientific community, some 
of whose members at that time considered the heart to be an area man could not tamper with.  
Obviously times were changing, and cardiac surgery was just beginning to develop into a 
realistic field with the development of extracorporeal bypass in the 50’s by Lillehei and 
Gibbon.

In 1950, Bigelow used open pacing in hypothermic heart experiments in animals [2].  Zoll 
was the first to develop a working application for humans [3].  He used external skin 
electrodes and a higher voltage to pace the heart across the chest.  We still use the Zoll 
pacemaker today for emergency situations.  It has many problems including skin burns, 
painful electrical currents and muscle contractions, and poor reliability especially in 
obese people and those with emphysema.  However it still does have applications.  

The first internal wire electrodes were developed in 1958.  Brockman paced an infant who 
developed complete heart block after repair of a VSD (ventricular septal defect) for about 
ten hours after which the patient expired [4].  Shortly thereafter, Furman and Schwegel 
used a right ventricular wire electrode to successfully pace a 76 year old man for 96 hours 
[5].  Both of these devices were connected to bulky external generators for power supply.

The first fully implanted pacemaker was developed by Elmquist and Senning in 1960 [6].  It 
used subcutaneously tunneled leads implanted on the surface of the heart, connected to a 
generator placed in and epigastric pocket (on the front of the abdominal wall below the 
skin).  The first so called “modern” pacemaker with an implanted generator and transvenous 
leads (leads that are passed through the vena cava onto the inner surface of the heart) was 
developed simultaneously in the US by Parsonnet and in Sweden by Ekestrom [7,8].  

There are many more developments which have ensued, but mostly which improve upon the 
original concept.  I have included references in case you wish to pursue some interesting 
historical reading.

1. Hyman AS, Resuscitation of the stopped heart by intracardial therapy. II:  experimental 
use of an artificial pacemaker, Arch. Int. Med., 50:283, 1932
2. Bigelow WG, et al., General hypothermia for experimental intracardiac surgery.  The use 
of electrophrenic respirations, an artificial pacemaker for cardiac standstill, and radio-
frequency rewarming in general hypothermia, Ann. Surg., 132:531, 1950
3. Zoll PM, Resuscitation of the heart in ventricular standstill by external electric 
stimulation, N. Engl. J. Med., 247:768, 1952
4. Brockman SK, et al., Monopolar ventricular stimulation for the control of acute 
surgically produced heart block, Surgery, 44:910, 1958
5. Furman S, Schwedel JB, An intracardiac pacemaker for Stokes-Adams seizures, N. Engl. J. 
Med., 261:943, 1959
6. Elmquist R, Senning A, Implantable pacemaker for the heart. In Smyth CN (Ed.):  Medical 
Electronics.  Proceedings on the Second International Conference on Medical Electronics, 
Paris, June 1959. London, Iliffe & Sons, Ltd., 1960
7. Parsonnet V, et al., An intracardiac bipolar electrode for interim treatment of complete 
heart block, Am. J. Cardiol., 10:261, 1962
8. Ekestrom S, et al., Behandling av Adams-Stokes syndrom med en intracardiell pacemaker 
elektrod, Opusc. Med., 7:1, 1962