The first implantable pacemaker was invented in 1958 by electrical engineer Rune Elmqvist. Since then, technology has improved dramatically.
The Abram-Lucus, 1961, induction-type cardiac pacemaker consisted of a power unit and two induction coils. Epicardial electrodes were connected to a coil sutured under the skin of the chest wall whilst another coil was secured onto the skin with adhesive tape. This latter coil was connected by wires to a battery operated pacing unit kept in a coat pocket and the pacing was done with electromagnetic induction. It was easy for the patient to renew the battery and adjust the rate, but the unit had to be worn at all times, a bath was difficult, and the external coil could get displaced. Some patients were paced in this way for 20 years. It was developed because available pacemaker circuits could be unreliable and had a short battery life. Invented by surgeon Leon Abrams, FRCS, in Birmingham and made by Joseph Lucas of Lucas Industries, an engineering company, in conjunction with the Queen Elizabeth Hospital. In 1964, Cardiologist Dr Peter Sleight and Cardiac Surgeon Dr Alf Gunning from South Africa implanted one of the first external Lucas cardiac pacemakers into a patient at the Radcliffe Infirmary, Oxford.
In 1969, the Australian company, Telectronics, was the first to use a metal case which prevented water diffusing through the epoxy resin and damaging the battery.
Early pacemakers stimulated the heart at a constant rate, rather than responding to the needs of the body, like speeding up during exercise. In the 1980s, British cardiologist Tony Rickards made and implanted the first pacemakers that could vary the pace of the heart.
The Abram-Lucus, inductively coupled pacemaker, 1961.
Early pacemakers were powered by mercury cells encapsulated in epoxy resin.
Plastron Device. An early implantable epicardial pacemaker.
Telectronics, 1969. First pacemaker to use a metal case.
Synergyst, 1988. An early dual chamber rate responsive unit.
The British Cardiac Society has a good collection of pacemakers dating back over 40 years on display in our museum. BCS extends its warm thanks to Dr David Dunham of Medtronic Ltd for valuable help in assembling its collection of pacing units, and to Dr R G Gold and Dr M D Gamage for kindly donating pacemakers.