Evolution of ticker technology

Sweden, the 1950s, Arne Larsson’s heart beats on average 28 times a minute. A normal heart should beat 70 times a minute. He’s dying. He has to be revived more than 20 times a day, and nothing exists which can save him. Yet.

Enter Dr. Rune Elmqvist, inventor of the world’s first pacemaker.

Dr. Elmqvist’s pacemaker was an external one, which delivered regular pulses of electricity to Larsson’s ailing heart, prompting it to beat with a more life­friendly regularity. It worked, but it had a limited shelf life. In the end, Larsson would go through 26 pacemakers, living to the age of 86, and even outliving Dr. Elmqvist.

Across the pond

Coincidentally also in 1958, a beat away across the Atlantic in New York, a prolific “humble tinkerer” named Wilson Greatbatch, was building a heart rhythm measuring device. He pulled out a wrong part from his toolbox, and whilst the device ended up not working as he had hoped, it did emit a strange, rhythmic pulse when activated.

Ever the curious inventor, Greatbatch built on his little accident, turning it into what would become the world’s first implantable pacemaker. Large, uncomfortable, and no doubt a devil to keep free of infections, Greatbatch’s pacemaker would still save countless lives.

Little bigger than a sunflower seed

Artificial pacemakers are an incredible invention, no doubt, but they come with leads and wires, which are uncomfortable, delicate and prone to all sorts of problems. These leads and wires would provide the inspiration needed for Cambridge Consultants and a then­startup company called EBR, to produce the world’s first wireless pacemaker.

So, how does it work?

The technology developed by Cambridge Consultants and EBR ­ known as WiSE ­ works in conjunction with a modern pacemaker, to regulate a person’s heartbeat. First, the pacemaker generates an electrical pulse to stimulate the right ventricle. A sensor located nearby in the heart measures this pulse, and sends an ultrasonic signal to a receiver little bigger than a sunflower seed (approximately 13.5mm x 2.6mm) attached to the inside of the left ventricle. The receiver then emits a pulse of its own, putting the two ventricles in sync with each other.

What does that mean for people who need a pacemaker?

It means greater freedom, from wires and infections, and the worry that comes with living an active lifestyle with protruding pacemaker wires.

The ultimate goal of Cambridge Consultants and their pacemaker­making partners, is to make pacemaker technology as small, reliable and as unobtrusive as possible. Arne Larsson survived for 43 years with his external pacer, and Wilson Greatbatch allowed us to become one with that technology. Now, as the pieces get smaller and the possibilities expand, our own hearts are racing with the ideas of what’s to come.

Explore further

EBR wireless pacemaker
Wilson Greatbatch, New York Times
History of the pacemaker