Talk:Artificial pacemaker

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Contents 1 Timeline 2 Article name 3 Power consumption 4 Possible copyvio? 5 Avoiding pacemaker rejection 6 seems to be jacked 7 Nuclear power?

[edit] Timeline

I'm trying to create a timeline for the history of artificial pacemakers:

1954 - First cardiac pacemaker stimulates a human heart - Used skin electrodes, caused skin burns.

1955 - Dr. Paul Zoll, MD, developed a pulse generator that stimulates the heart. Manufactured as the PM-65 by Electrodyne, it was intended for use as emergency support during cardiac surgery.

1957 - After a power outage caused a PM-65 to stop functioning, Dr. C. Walton Lillehei asked Earl Bakken to create a device that worked on batteries. This prototype lead to the 5800 line of pacemakers by Medtronic, the first wearable external pacemaker. This device was also the first with implantable internal electrodes.

1958/Oct/8 - Under the direction of Dr. Åke Senning, Rune Elmqvist developed the first fully implantable pacemaker. The first implantation was performed on a Swedish man named Arne Larsson. He was 43 y/o at the time, and suffered from life-threatening Stokes-Adams seizures. (The first device worked for three hours. A second one was inserted the next day, which worked for a couple of weeks. In 1971 Mr. Larsson got a device that worked well. Mr. Larsson lived a long and full life until his death on December 28, 2001. Over his lifetime, Mr. Larsson received a total of 22 pacemakers over 43 years.) The power supply for this first pacemaker was two NiCad battery cells which were rechared from the outside by a coil. The battery cells and the silicon transistors were encased in an epoxy resin. The entire pacemaker device (excluing leads) measured 55mm diameter by 16mm thickness.

1959/May/19 - First long term transvenous pacing wire used. A 67 year old male with high degree heart block underwent insertion of a transvenous lead via cephalic vein cut down. The transvenous wire was attached to an externalized pacing system via the skin incision. The pacing system was able to sense native ventricular activity, but was not able to inhibit pacing output based on sensed activity. The gentleman was discharged from the hospital on June 23, 1959. Because the pacing lead exited through the skin, the skin site required frequently infected. However he never developed a systemic infection due to the pacing system. After using the device for 41 months, he underwent implantation of a completely internal pacemaker system on November 8, 1962. He died 20 days later due to complications from the surgery.

1959 - Dr. William Chardack and Dr. Andrew Gage at the Veterans Administration Hospital in Buffalo, N.Y., working with William Greatbatch (an electrical engineer), developed the (first) a fully implantable pacemaker using primary cells as a power source.

1960/Feb/3 - Orestes Fiandra MD and Roberto Rubio MD implanted the first pacemaker in the Western Hemisphere in a 40 year old woman with complete heart block and syncopal episodes. The device worked for the 9 months that the patient survived her other ailments. The device was designed in cooperation with, and produced by, Rune Elmqvist.

1960/Jun/6 - Chardack, Gage and Greatbatch implanted a self-contained, completely internal pacemaker powered by a non-rechargeable mercury zinc oxide batteries, in Buffalo, USA. The patient died 2 years later of unrelated causes.

1960/Jul - Greatbatch files for a patent on the implantable pacemaker. It is granted(!)in 1962.

1960 - Medtronic creates (first)a long-term implantable pacemaker system

1972 - Cardiac Pacemkers, Inc. (Guidant) creates first pacemaker with lithium battery

1974 - Plutonium battery devices in use.

References:

http://www.mnhs.org/collections/medTech/org_cardiac_pacemakers.html

http://www.naspe.org/ep-history/timeline/

http://www.medtronic.com/corporate/history.html

http://www.bae.ncsu.edu/bae/courses/bae465/1995_projects/scho/htmls/history1.html

http://inventors.about.com/library/inventors/blcardiac.htm

---

How about this one?

• History of Pacemakers

--Smithfarm 15:04, 14 August 2006 (UTC)

[edit] Article name

Isn't "artificial pacemaker" redundant? Shouldn't this article be at Heart pacemaker or something like that? RickK | Talk 02:50, 6 Apr 2004 (UTC)

The first sentence covers that. The heart contains natural pacemaker cells, described at Cardiac pacemaker. -- Cyrius|&#9998 03:28, Apr 6, 2004 (UTC)

There is some "first"-words that can be removed when discussing Greatbatch. I have put them in parenthesis above. This as the swedish device was really the first to be implanted, and that the Uruguay one was the first long-live one. I also added some details about the Swedish devices. The development of these devices continued, and pacemakers are still being produced and developed in Sweden, now under the name of St. Jude Medical Inc. One of their products is the worlds smallest pacemaker.

Ake Senning and Rune Elmqvist did present their pacemaker design on the second international conference on medical electronics in Paris in june 1959. The title of their abstract is "An implantable pacemaker for the hearth."

[edit] Power consumption

What's the typical power consumption of an artificial pacemaker? 193.171.121.30 00:58, 13 May 2005 (UTC)

[edit] Possible copyvio?

The text at the end of the page seems to be copied directly from the middle part of [1], ?s and all (before I corrected the ?s into 's anyway). However, it also appears in some other pages in the google cache, such as [2] (currently 404'd at the original url) The text was added in [3] by 144.15.16.71, which has no other contributions. Should this be removed, or has authorization for the use of this text been given at some time in the past? -- bd_ 00:17, 25 Feb 2005 (UTC)

• I removed it. Osmodiar 06:56, 3 Apr 2005 (UTC)

It looks like this article is almost identical to one found here: http://www.thedoctorslounge.net/cardiology/procedures/pacemaker.htm. Doctor's lounge says it is copyrighted... question is who copied from whom? Nephron 06:21, 21 March 2006 (UTC)

Why did you remove the whole article? Large parts of the wikipedia article is not the same as the linked one. And still no indication of who has copied who. If you look at the history of the page, you can see the evolution of the article. (And I have made parts of the contrubution myself.)Please reinstate immediatly. I think that these kind of actions is the same as vandalism. 09:45, 21 March 2006 (UTC)

[edit] Avoiding pacemaker rejection

Discussion copied from Wikipedia:Reference desk/Science. Jay 11:44, 10 February 2006 (UTC)

What is done to avoid the body's immune system treating an artificial pacemaker as a foreign body and creating anti-bodies to reject it ? Jay 08:03, 2 February 2006 (UTC)

Immunosuppressive drugs are the most common technique. -- Daverocks (talk) 10:05, 2 February 2006 (UTC)

I actually had checked out the Immunosuppressive drug article. It talked of natural organ translpants, but there was no mention of artificial organ transplants. Will the case with artifical be a lot different ? Jay 12:48, 2 February 2006 (UTC)

The chemical makeup of the casing is so designed that it will rarely cause problems. The whole thing will not be rejected, and will be encapsulated by scar tissue, in the same way a piercing is. -- Ec5618 11:21, 2 February 2006 (UTC)

Can you give some link to this ? I would like to add all this to the article. Jay 12:48, 2 February 2006 (UTC)

Immunosuppressive drugs are not used when mechanical devices (or even non-living biomechanical devices such as a porcine heart valve) are implanted. Such devices do not provoke a Type IV hypersensitivy immunological response. - Nunh-huh 20:02, 2 February 2006 (UTC)

Oh. Whoops. I guess I shouldn't talk from now on, considering I'm not a physicist physician. Must stop getting my words mixed up. -- Daverocks (talk) 06:11, 3 February 2006 (UTC)

The outser casing of pacemakers is often (usually?) made of titanium, which is very inert in the body. It is also used for joint replacements and some dental prostheses, for the same reason. Physchim62 (talk) 20:55, 2 February 2006 (UTC)

[edit] seems to be jacked

http://www.reference.com/browse/wiki/Artificial_pacemaker

--Jaysscholar 18:57, 19 February 2006 (UTC)

The above is alright. At the bottom of the page it says:

Source: Wikipedia, the free encyclopedia © 2001-2006 Wikipedia contributors (Disclaimer)

This article is licensed under the GNU Free Documentation License.

I'm not sure I can say the same about http://www.thedoctorslounge.net/cardiology/procedures/pacemaker.htm. Nephron 06:26, 21 March 2006 (UTC)

• Can someone check on the Wayback machine to see what it shows for the doctors lounge page? If not, I'll do it in about 10 hours when I get home. The work proxies block access to wayback, and it's not worth it for me to go around them for this. Wikibofh_(talk) 14:12, 21 March 2006 (UTC)

• My guess is that the copyvio goes the other way, but I can't prove it. For this stuff the earliest I can find the article on thedoctorslounge is May 18th, 2004. The text in question is added to the article on January 9, 2003. I would argue it likely is NOT a copyvio. Wikibofh_(talk) 22:50, 21 March 2006 (UTC)

I was unable to find anything on the wayback machine, but maybe I didn't use it correctly. By reviewing the edit history for this article, its pretty clear that much of the basic structure of the WP article dates back to 2003 and approaches its current form fairly well by 2004. As best as I can tell, the doctors-lounge article was copied from WP in summer 2004. I'm using the opening sentence of the third paragraph as evidence:

The first pacemakers required wires (called leads) to be placed surgically on the

which is added on 5 April 2004 by User:Ksheka [4], but is modified into its current form on 28 December 2004 in a large edit by anon User:144.15.16.71 [5]. .

Meanwhile, the 5 April 2004 version of the WP article ends its opening paragraph with

Generally, pacemakers do not treat fast rhythms of the heart.

which is absent from the doctorslounge article. This sentance was removed from WP on 19 September 2005 by User:202.156.2.147 in this edit: [6] The doctorlounge article seems to have been copied from WP between april and december 2004, but subsequently edited to track the newer intro paragraphs that WP has. This seems to indicate that the doctorslounge article is not just a one-time copy from WP, but is repeatedly edited to track WP. linas 03:30, 22 March 2006 (UTC)

• I did manage to use the wayback machine (once at home) which is where I got my dates. I've commented on the copyvio page. Given all of this, I'm going to revert to the pre-copyvio version. Wikibofh_(talk) 03:43, 22 March 2006 (UTC)

Interesting research. Is there someone that will write a friendly email to Doctor's Lounge about this? Awaiting curiously to see how this will develop, Nephron 04:01, 22 March 2006 (UTC)

• • Normally this happens via mirrors and forks, for what it's worth. I don't really care to do it though.  :) Wikibofh_(talk) 04:40, 22 March 2006 (UTC)

[edit] Nuclear power?

The first American-made nuclear-powered pacemaker was developed and implanted by ...

From this sentence I get the idea that pacemakers do not use ordinary batteries, but instead some kind of nuclear power. However the article has precious little to say about it. Anyone care to expand on this? --Smithfarm 14:51, 14 August 2006 (UTC)