University at Buffalo School of Medicine & Biomedical Sciences, Buffalo, New York, USA.
Am J Cardiol. 2010 Sep 15;106(6):810-8. doi: 10.1016/j.amjcard.2010.04.043.
June 2010 marks the 50th anniversary of the first successful human cardiac pacemaker implantation in the United States. On June 6, 1960, in Buffalo, New York, Dr. William Chardack implanted a pacemaker, designed and built by Wilson Greatbatch, an electrical engineer and inventor, in a 77-year old man with complete atrioventricular block, extending the patient's life by 18 months. This landmark event ushered in a new era of implantable cardiac pacemakers with batteries and leads of high reliability and increasing durability. Over the past half century, the field of electrophysiology and implantable devices for the management of cardiac conduction disturbances has evolved dramatically. Today's pacemakers include increasingly complex features such as telemetry monitoring, auto programmability, and hemodynamic sensors. New-generation leads present a sophisticated design with improved geometry and steroid-eluting tips to reduce chronic inflammation, maintaining a low pacing threshold and high sensing capability. The lithium iodide battery remains the mainstay of implantable pacemaker systems, exhibiting a multiple-year lifespan, slow terminal decay, and a reduced size and cost of production. Although Greatbatch's first successful pacemaker implantation remains a seminal scientific contribution to modern cardiovascular disease management, emerging developments in this field may challenge its preeminence. Important challenges such as imaging compatibility, lead durability, and infection prevention are being addressed. Novel concepts such as leadless and biologic pacing are under active investigation. In conclusion, Greatbatch's historic achievement 50 years ago reminds us that technologic progress is timeless, as efforts to enhance clinical outcomes and the quality of life continue unimpeded into the 21st century.
2010 年 6 月标志着美国首例成功植入心脏起搏器的 50 周年。1960 年 6 月 6 日，在纽约州布法罗，William Chardack 医生为一位患有完全性房室传导阻滞的 77 岁男性患者植入了一个由电气工程师兼发明家 Wilson Greatbatch 设计和制造的起搏器，使患者的生命延长了 18 个月。这一具有里程碑意义的事件开创了一个电池和导联具有高可靠性和不断提高耐用性的可植入心脏起搏器的新时代。在过去的半个世纪里，心脏电生理和用于管理心脏传导障碍的植入设备领域发生了巨大的变化。如今的起搏器包括越来越复杂的功能，如遥测监测、自动程控性和血液动力学传感器。新一代导联采用了改进的几何形状和类固醇洗脱尖端的复杂设计，以减少慢性炎症，保持较低的起搏阈值和较高的感知能力。锂离子碘电池仍然是可植入起搏器系统的主要组成部分，具有多年的使用寿命、缓慢的末期衰减以及更小的尺寸和更低的生产成本。尽管 Greatbatch 首次成功植入起搏器仍然是现代心血管疾病管理的开创性科学贡献，但该领域的新兴发展可能会挑战其卓越地位。正在解决一些重要的挑战，如成像兼容性、导联耐久性和感染预防。一些新的概念，如无导线和生物起搏，正在积极研究中。总之，Greatbatch 在 50 年前的历史性成就提醒我们，技术进步是永恒的，因为在 21 世纪，人们仍在努力提高临床疗效和生活质量，这一努力不受任何阻碍。
