You’ve probably seen the scars. Maybe it’s on a grandparent or a friend who suddenly got their energy back after years of "slowing down." That little bump under the skin near the collarbone is basically a medical miracle, a tiny computer that keeps the heart’s rhythm from falling off the tracks. But if you try to pin down exactly who invented the pacemaker, you're going to get a messy answer. It wasn't some lone genius shouting "Eureka!" in a bathtub.
It was a decades-long relay race.
Honestly, the history of pacing is kind of gruesome if you look back far enough. We’re talking about a timeline that stretches from Victorian-era doctors experimenting with "galvanism" on executed criminals to a guy accidentally grabbing the wrong resistor in a backyard shed in Buffalo. It involves engineers, heart surgeons, and a surprising amount of car batteries.
The early sparks of an idea
The core concept is simple: the heart runs on electricity. If the natural internal wiring breaks, you need an external spark. Back in the 1920s, an Australian doctor named Mark Lidwill realized this. He was working at a hospital in Sydney and came up with a portable device that could poke a needle into a baby's heart to deliver an electrical pulse. It actually worked. He saved a life. But Lidwill was a humble guy—or maybe just wary of the "Frankenstein" vibes—and he refused to patent it or take much credit.
Then came Albert Hyman in 1932. He’s the one who actually coined the term "artificial pacemaker." His machine was a hand-cranked beast. Imagine a doctor frantically cranking a handle to keep a patient alive. It wasn't exactly something you could carry around in your pocket. Medical journals at the time actually attacked him for "interfering with the will of God."
People were terrified of it.
The war years and the "Big Box" era
Everything changed because of a blackout. In 1957, a massive power failure hit Minnesota. At the time, "portable" pacemakers were these heavy boxes that plugged into the wall. When the power went out, children who depended on these machines at the University of Minnesota died. It was a tragedy that broke the heart of Dr. C. Walton Lillehei, a pioneer in open-heart surgery.
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Lillehei didn't go to a massive corporation for help. He went to a guy named Earl Bakken, who ran a tiny medical repair shop out of a garage.
Bakken was a tinkerer. He took a circuit design for a metronome—the kind piano players use—and modified it. Within four weeks, he handed Lillehei the first battery-powered, wearable pacemaker. It was about the size of a thick paperback book and hung around the patient's neck. This wasn't just a technical win; it was the birth of Medtronic.
But there was still a massive problem. The wires went through the skin. This meant infections were constant, and the patient was literally tethered to a box.
The accidental invention of the implantable version
This is where the story gets really weird. Enter Wilson Greatbatch. He was an electrical engineer working on a device to record heart sounds. In 1956, he reached into a box of parts and pulled out a resistor. He grabbed the wrong one.
When he soldered it into the circuit, the device didn't record sounds. Instead, it emitted a steady, rhythmic electrical pulse.
Pulse.
Pause.
Pulse.
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Greatbatch stared at it. He realized that this tiny circuit could drive a heart. He spent the next two years in his barn, potting the electronics in epoxy resin to protect them from body fluids. He teamed up with Dr. William Chardack and Dr. Andrew Gage at the Buffalo Veterans Administration Hospital. In 1960, they successfully implanted the device into a human. It was the first time a person could walk around with a heartbeat controlled entirely from the inside.
Around the same time over in Sweden, Rune Elmqvist and surgeon Ake Senning were doing something similar. Their first patient, Arne Larsson, actually outlived the surgeon and the engineer. He went through 26 different pacemakers in his lifetime, but he lived to be 86. Before the pacemaker, he was having dozens of fainting spells a day. After? He was back to being an engineer.
Why the battery was the real hero
If you ask a cardiologist today who invented the pacemaker, they might give a nod to the battery experts. Early models used nickel-cadmium batteries that had to be recharged through the skin using induction coils. It was a nightmare. If the battery died, the patient died.
The game-changer was the lithium-iodide battery.
Wilson Greatbatch (the "wrong resistor" guy) was also the one who pioneered the use of these batteries in the early 1970s. They could last ten years instead of two. This transformed the pacemaker from a "hail mary" surgery into a routine procedure.
Modern pacing and what's next
We've come a long way from hand-cranked machines and barn-built circuits.
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- Leadless Pacemakers: These are tiny, capsule-shaped devices (like the Micra) that are placed directly inside the heart's chamber via a catheter. No wires, no "pocket" in the chest.
- Bi-Ventricular Pacing: This coordinates the left and right sides of the heart for people with heart failure.
- Smart Monitoring: Your pacemaker now talks to your phone, which talks to your doctor.
Myths vs. Reality
People often think Paul Zoll invented it. He definitely popularized external pacing in the 1950s (the kind of pads they use in ER shows), but he didn't make the first internal one. Others think it was a NASA invention. While NASA tech helped with miniaturization and telemetry, the heart-pacing part was purely the work of independent medical nerds and surgeons.
The reality is that "who invented the pacemaker" is a group answer. Lidwill proved it was possible. Bakken made it portable. Greatbatch and Elmqvist made it internal.
Actionable steps for heart health
If you or a family member are looking into pacing options, don't just settle for the "standard" talk. Cardiology moves fast.
- Ask about leadless options. If you only need single-chamber pacing, a leadless device avoids the most common complication: lead fracture or infection.
- Verify the MRI status. Most modern pacemakers are "MRI-conditional," meaning you can safely get an MRI. If you have an older model (pre-2010), you must check the serial number with your electrophysiologist before going near a magnet.
- Monitor the "Battery Life" remotely. Ensure your clinic sets up a home monitoring station. It’s a small box by your bed that pings the clinic if the device detects an arrhythmia or if the battery is getting low.
- Understand the "Replacement" procedure. When the battery runs low, they don't usually replace the whole system. They just open the small pocket, swap the generator, and plug the existing wires back in. It’s often a 30-minute outpatient job.
The history of the pacemaker is a reminder that mistakes—like grabbing the wrong resistor—can change the world. Today, millions of people are walking around with a little bit of 1950s metronome technology tucked under their skin, and they’re doing just fine.
Summary of Key Figures
- Mark Lidwill: The first to use a needle electrode on a human (1926).
- Albert Hyman: Created the "pacemaker" name and a hand-cranked version (1932).
- Earl Bakken: Made it portable using a metronome circuit (1957).
- Rune Elmqvist: Designed the first truly implantable version in Sweden (1958).
- Wilson Greatbatch: Invented the reliable, long-term implantable pacemaker and the lithium battery that made it practical (1960).
Knowing the lineage helps you appreciate just how robust these devices have become. They aren't just gadgets; they are the result of a century of people refusing to let a stopped heart stay stopped.