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Wilson Greatbatch, an electrical engineer in Buffalo, NY, had a brilliant idea and the technical know-how to turn his idea into a practical device, for which millions of people today are grateful. This is the story of the first pacemaker by the man who invented it. Intrigued by electronics from the time he was a boy, Greatbatch earned a degree in electrical engineering from Cornell University. It was during his time at Cornell that he first became interested in the medical applications of electronic devices. He learned about the problem of heart blocking at Cornell and knew it was fixable in principle, but at the time the vacuum-tube technology was impractical for medical use. By the 1950s he was teaching at the University of Buffalo School of Electrical Engineering and the first silicon transistors had just been invented. While using one of the new $90 transistors on another project Greatbatch discovered by accident, as he describes it, the proper design for a blocking oscillator that he immediately knew would work as a pacemaker. He soon interested Dr. William Chardack, chief of surgery at the Veteran''s Administration Hospital in Buffalo, in the project, and by 1958 they were conducting animal experiments. Greatbatch quit his job and for the next two years devoted full-time in his wood-heated barn workshop to building one pacemaker after another. During this time he built fifty pacemakers, forty of which went into animal experiments. By 1960 he and a team of surgeons and engineers had gained enough knowledge from the trial and error of the animal experiments to feel ready to begin implanting the remaining ten devices in people. The first trials went well and Greatbatch''s device extended the lives of many of these seriously ill patients by decades. What followed were years of hard work refining the battery and electrode technology, marketing the pacemaker to an initially skeptical medical community, and keeping the company that manufactured the device profitable. Reminiscent of Edison''s many dogged attempts to find the right solution in pursuit of an ingenious idea, The Making of the Pacemaker is a human-interest story at its best and also an important firsthand account for the medical archives of an invention that today saves millions of lives.
Today hundreds of thousands of Americans carry pacemakers and implantable cardioverter-defibrillators (ICDs) within their bodies. These battery-powered machines—small computers, in fact—deliver electricity to the heart to correct dangerous disorders of the heartbeat. But few doctors, patients, or scholars know the history of these devices or how "heart-rhythm management" evolved into a multi-billion-dollar manufacturing and service industry. Machines in Our Hearts tells the story of these two implantable medical devices. Kirk Jeffrey, a historian of science and technology, traces the development of knowledge about the human heartbeat and follows surgeons, cardiologists, and engineers as they invent and test a variety of electronic devices. Numerous small manufacturing firms jumped into pacemaker production but eventually fell by the wayside, leaving only three American companies in the business today. Jeffrey profiles pioneering heart surgeons, inventors from the realms of engineering and medical research, and business leaders who built heart-rhythm management into an industry with thousands of employees and annual revenues in the hundreds of millions. As Jeffrey shows, the pacemaker (first implanted in 1958) and the ICD (1980) embody a paradox of high-tech health care: these technologies are effective and reliable but add billions to the nation's medical bill because of the huge growth in the number of patients who depend on implanted devices to manage their heartbeats.
This specialist handbook is a practical, comprehensive, and concise training guide on how to implant, follow-up, and troubleshoot pacemakers and ICDs, fully updated with new technologies and the latest international guidelines.
An essential companion for both the aspiring and practising electrophysiologist, The EHRA Book of Pacemaker, ICD and CRT Troubleshooting assists device specialists in tackling both common and unusual situations that that they may encounter during daily practice. Taking a case-based approach, it examines pacemakers, implantable cardioverter defibrillators and cardiac resynchronisation therapy. Much more than just a technical manual of device algorithms, the cases help readers to consolidate their technical knowledge, and improve their reasoning and observation skills so they are able to tackle device troubleshooting with confidence. The 70 cases are arranged in three sections by increasing levels of difficulty to walk readers through all the skills and knowledge they need in an easy to use and structured format. Each case contains a short clinical description and a device tracing followed by a multiple choice question. Answers are supplied with detailed annotations of the tracing and an in-depth discussion of the case, highlighting practical hints and tips as well as providing an overview of the technical function of devices. A useful summary of principal device features and functions is also included. The EHRA Book of Pacemaker, ICD and CRT Troubleshooting is the perfect companion for electrophysiologists, cardiology trainees and technical consultants working with device patients as well as for those studying for the EHRA accreditation exam in cardiac pacing.
Fully revised and updated, the fourth edition of Cardiac Pacingand ICDs continues to be an accessible and practical clinicalreference for residents, fellows, surgeons, nurses, PAs, andtechnicians. The chapters are organized in the sequence of the evaluation ofan actual patient, making it an effective practical guide. Revisedchapters and updated artwork and tables plus a new chapter oncardiac resynchronization make the new edition an invaluableclinical resource. Features: · New chapter on Cardiac Resynchronization Therapy · Updated and better quality figures and tables · Updated content based on ACC/AHA/NASPE guidelines · Updated indications for ICD placement · Updated information on ICD and pacemakertroubleshooting
This new edition of the bestselling step-by-step introduction to cardiac pacemakers now includes additional material on CRT and an accompanying website. It retains the effective use of full-page illustrations and short explanations that gained the book such enormous popularity and now provides information on recent advances in cardiac pacing, including biventricular pacing for the treatment of heart failure.
While there are many excellent pacing and defibrillation books, they are nearly all written by physicians for physicians. The second edition of the successful The Nuts and Bolts of Cardiac Pacing has been thoroughly updated, reflecting the new challenges, issues, and devices that clinicians deal with. Written specifically for non-cardiologists in a lively, intelligent and easy to follow style, it emphasizes real-life clinical practice and practical tips, including illustrations from actual clinical settings. Each chapter concludes with a checklist of key points from each subject ("Nuts and Bolts"). New features to the second edition include: updated terminology and images reflecting new software developments information on new innovations and advanced features, such as ventricular intrinsic preference and AF suppression new features on the automatic atrial capture test and follow-up features new chapter covering clinical studies on the possible dangers of excessive RV pacing Building layer by layer on the fundamental principles and concluding with advanced concepts, The Nuts and Bolts of Cardiac Pacing is intended for a novice to appreciate overall concepts and for a seasoned veteran to turn to answer a specific question. This book offers practical, reliable and objective information on cardiac devices – it's easy to pick up, find what you need, and put down.
This hands-on approach to cardiac lead extraction is presented in a case-based format and complemented by more than 200 videos demonstrating state-of-the-art tools, methodology, technical skills, and periprocedural clinical management critical for successful outcomes. There is a worldwide increase in extraction procedures due to pacemaker or defibrillator leads becoming infected or dysfunctional. This visual atlas with 26 illustrative cases informs cardiology providers about the latest techniques and tools available for the procedure. The teaching objectives of this book will guide the reader to: · Plan a lead extraction procedure based on the individual case. · Review detailed technical aspects of a lead extraction procedure. · Troubleshoot challenging and complex cases. · Develop strategies to prevent, diagnose, and manage complications associated with lead extraction procedures. The book will serve as an easy reference guide for cardiac electrophysiologists, cardiologists, anesthesiology providers, allied health staff members, fellows, and surgeons performing lead extraction procedures. Also included is a special section on team dynamics and the valuable role of allied health providers in lead extraction procedures. The ability to learn from the collective wisdom of the lead extraction community is a game-changer…This compendium showcases a breadth of techniques and expertise that extends far beyond what any individual could achieve. From the Foreword, Joshua M. Cooper, MD Illustrated with 220 videos and 235 figures.
This workbook explains in simple, step-by-step terms how to introduce and sustain lean flows of material and information in pacemaker cells and lines, a prerequisite for achieving a lean value stream.A sight we frequently encounter when touring plants is the relocation of processing steps from departments (process villages) to product-family work cells, but too often these "cells" produce only intermittent and erratic flow. Output gyrates from hour to hour and small piles of inventory accumulate between each operation so that few of the benefits of cellularization are actually being realized; and, if the cell is located upstream from the pacemaker process, none of the benefits may ever reach the customer.This sequel to Learning to See (which focused on plant level operations) provides simple step-by-step instructions for eliminating waste and creating continuous flow at the process level. This isn't a workbook you will read once then relegate to the bookshelf. It's an action guide for managers, engineers, and production associates that you will use to improve flow each and every day.Creating Continuous Flow takes you to the next level in work cell design where you'll achieve even greater cost and lead time savings. You'll learn: where to focus your continuous flow efforts, how to create much more efficient work cells and lines, how to operate a pacemaker process so that a lean value stream is possible, how to sustain the gains, and keep improving.Creating Continuous Flow is the next logical step after Learning to See. The value-stream mapping process defined the pacemaker process and the overall flow of products and information in the plant. The next step is to shift your focus from the plant to the process level by zeroing in on the pacemaker process, which sets the production rhythm for the plant or value stream, and apply the principles of continuous flow.Every production facility has at least one pacemaker process. The pacemaker processes is usually where products take their final form before going to external customers. It’s called the pacemaker because how you operate here determines both how well you can serve the customer and what the demand pattern is like for your upstream supplying processes.How the pacemaker process operates is critically important. A steady and consistently flowing pacemaker places steady and consistent demands on the rest of the value stream. The continuous flow processing that results allows companies to create leaner value streams.[Source : 4e de couv.]
Different artificial tools, such as heart-pacing devices, wearable and implantable monitors, engineered heart valves and stents, and many other cardiac devices, are in use in medical practice. Recent developments in the methods of cardiac pacing along with appropriate selection of equipment are the purpose of this book. Implantable heart rate management devices and wearable cardiac monitors are discussed. Indications for using specific types of cardiac pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators (ICDs) are of interest and their contraindications are considered. Special attention is paid to using leadless devices. The subcutaneous ICD obviates the need for transvenous leads and leadless pacemakers are entirely implantable into the right ventricle. Finally, applications of user-friendly wearable devices for the detection of atrial arrhythmia are debated.