Implantable Cardiac Pacemakers – 50 Years from the First Implantation

Background:There are over 4 million people around the world living with implanted cardiac devices. Modern pacemakers are small and light medical devices, which are implanted under local anaesthesia and provide therapy for a broad range of cardiac diseases. h ey are extremely safe, reliable and long lasting. h e aim of this paper is to present review of the development of implantable pacemakers from an engineering point of view since the i rst implanted device in October 1958 till today. Overview: Development of implantable cardiac pacemaker was enabled by another important invention, the silicon transistor. h ough the invention of suitable lithium cells as appropriate power supply was essential for prolongation of battery life cycle and for increased reliability of pacemakers, main milestones in the development were associated with technological breakthroughs in electronics: from transistors, which introduced such features as small size and low power consumption, to hybrid and integrated circuits, which enabled programmability, microprocessors, which added more options in programming (multiprogrammability), diagnostics and telemetry, and the ICT (information communication technology) that enabled physicians remote access to patients and interrogation of their implantable devices. Conclusions: Implantable pacemakers are reliable devices indicated for a wide range of dif erent therapies of cardiac rhythm disorders and heart failure. h ere is still a lot to learn about the physiology of a normal heart and even more about the failing heart. Modern pacemakers provide physicians valuable information from pacemakers’ memory via the built-in telemetry system. h ese information help physicians to better understand pathologic processes within the heart, thus contributing to the development of new ideas for treatment of diseases and for precise tailoring of the therapy to the patient’s needs. Although implantable pacemakers have reached the level of mature technology, they will continue to develop with therapies and diagnostics to facilitate a higher quality of life.