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... In early 1930, Albert S. Hyman, a cardiologist in New York City, invented an artificial pacemaker, in which, output voltage was generated by a magneto-generator driven by winding a hard rank. 20 However, all these methods were proved to be ineffective. ...
Understanding of cardiac rhythm requires application of physical principles governing electricity. Over a period of more than 100 years, application of the knowledge of electric current led to the gradual evolution of electrocardiogram, pacemaker, defibrillator, and ultimately electrophysiology. The discovery of electrocardiogram (ECG) by Einthoven in 1902 and that of pacing by Zoll in 1952 were two landmarks in this field.
The concept of electrical energy being a complement of human tissue goes back centuries. Early studies included both animal and human evaluation. Electrical engineering advances continued in the 20th century ultimately resulting in the first implantable pacemaker in 1958 by the Swedish heart surgeon Ake Senning. Initial pacing leads were implanted for bradycardic support. These leads consisted of a conductor, insulator, electrode, and conductor pin. As pacing and defibrillator leads advanced, variable sizes and materials resulted in different histological effects on the vascular tissues and myocardium.
As soon as pacing leads were developed and implanted, the practical need for extraction existed. Extraction requires consideration of proper debulking strategy to encounter the resistance that stems from the interaction of biotissues with the leads. Techniques in lead extraction advanced along with the leads’ technological developments. Accordingly, extraction techniques included mechanical tools that then developed to include specialized powered sheaths. Thus, based on the degree of vascular fibrosis, calcification, and mineralization different tools may be utilized for optimized debulking for lead removal. Safe and effective lead extraction requires advanced training, teamwork, and a commitment to safety protocols. Eventually, a new pacing system design may eliminate the need for utilization of intravascular leads and, consequently, may change the realm of lead explanation and removal.
Since the advent of electricity, it was postulated that control of the heartbeat could potentially save countless lives. But artificially pacing the heart remained a dream for most of human history. In this chapter, the author discusses the contributions of several pioneers in the field of cardiac pacing from the mid-twentieth century to today.
If you had bought a copy of the American magazine ‘Popular Mechanics’ in March 1933, you would have seen the announcement of two remarkable new machines on the same page.1 One of these was an automated bread slicer. “Bread is cut and spread with butter or jam at the turn of a crank”, the report explained. “It has a capacity of sixty slices a minute. The thickness of the slice and the spread can be regulated, and no special preparation of either the bread or the butter is necessary.” The other, slightly longer report described a different crank-driven machine, under the heading “Beating of heart is revived by electrified needle.” It gave an account of an apparatus called “the artificial pacemaker.” “When the heart stops”, the article reported, “the needle is inserted into the right auricle. Electrical impulses of low power are applied with a generator. These impulses can be regulated to forty, eight or 120 beats per minute, depending on the age of the patient and the normal rate of his heartbeat. Where the operation is successful, the electrical stimuli restore the inert heart to its natural beat”.
This is an article on the history of artificial cardiac pacemakers. Before the advent of pacemakers, not much could be done
for patients who suffered from cardiac asystole and other cardiac rhythm disturbances. Although the concept that an artificial
pacemaker could be used to stimulate the heart in standstill evolved much earlier, it was not until 1952 that the first case
of successful pacing of the human heart could be documented. From that time onwards, pacemakers have seen tremendous technological
advancements—not only in terms of pacemaker efficacy, but also in terms of patient safety. The outstanding amongst these include
the development of myocardial and endocardial electrodes and the invention of a transistorized external pacemaker with a battery
backup. With the development of the first implantable pacemaker, the cherished dream of long term pacing came true. At the
same time, recognition of pacemaker induced arrhythmias gave an impetus to the evolution of safer modes for cardiac pacing.
Though journal articles and newspaper reports suggest that three Hyman pacemakers existed or were intended; a patent, descriptive photographs and a written description of an earlier model and only a photograph of a later model exist. A replica of the earlier has been made based on the patent and description, and a new replica of the second based on a critical deconstruction and analysis of the photograph of the second with a modern circuit duplicating the function of the earlier circuit. Both replicas were "operational" in that stimuli were mimicked though not delivered and neither could under any circumstances actually resuscitate the heart. The design and construction of the second Hyman pacemaker are presented.
THE FACTS COLLECTED IN THE THIRD PART OF THIS PAPER JUSTIFY THE FOLLOWING CONCLUSIONS: (1) All of the cardinal symptoms of Stokes-Adams disease may be duplicated by heart-block resulting from a lesion in or near the auriculo-ventricular bundle of His, and by this alone. (2) No typical case of Stokes-Adams disease has been described in which heart-block might not have been the cause of the trouble. (3) It can be shown that all cases of Stokes-Adams disease which have been studied by sufficiently accurate methods were cases of heart-block. (4) It would appear that heart-block without and with syncopal attacks are two stages of the same disease process.
1.
Im Tierversuch wird die Wirkung des Biomotors nachgeprft. Es kann gezeigt werden, da die abdominelle Atmung durch Saug- und Druckluft allen anderen Wiederbelebungsmethoden berlegen ist und auch ein gnstiger Einflu auf den Kreislauf ausgebt wird.
2.
Vergleichsversuche mit manueller knstlicher Atmung, mit elektrischen Reizen (Hymanotor), mit Cardiazol und Lobelin (intravens, intrakardial und suboccipital) haben, zudemselben Zeitpunkt wie der Biomotor angewandt, keine Erfolge gezeigt.
3.
Der Begriff Scheintod wird definiert: Stillstand von Atmung und Kreislauf mit zur Nullinie abgesunkenem Blutdruck, aber ohne Strung des Reizleitungssystems des Herzens.
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