Speaker 1: Get in tests with technology with text stuff from half
Speaker 1: stuff works dot com. Hey there, and welcome to textuff
Speaker 1: on Jonathan Stricklin. Today we're going to talk about pacemakers.
Speaker 1: So these little medical devices that are incredible. I mean,
Speaker 1: these are life saving devices that have made countless people's
Speaker 1: lives better. It's impossible. It's it's when when the electrical
Speaker 1: impulses of your heart are less good than they should be. Wait, whoa,
Speaker 1: whoa electrical impulses, Lauren, Now you're talking crazy talk. What
Speaker 1: do you mean electrical impulses. That's that's how the heart works.
Speaker 1: There's crazy there. We we we have natural pacemakers, and
Speaker 1: sometimes they work less well than others. But so yeah,
Speaker 1: so so. Pacemakers are are small devices that are implanted
Speaker 1: nearish the heart, in the general chest, airs, cavity, shoulder,
Speaker 1: abdomen's where on there. They use low energy electrical impulses
Speaker 1: to help control any abnormal heart rhythms um sometimes called
Speaker 1: arrhythmias rhythmia. Thank you, I had an arrhythmia as a child,
Speaker 1: did you. Yep? I had an arrhythmia and a heart murmur.
Speaker 1: Wow that's exciting in the bad way. So anyway, so
Speaker 1: those can be that your heart is beating either too fast,
Speaker 1: too slow, or irregularly. And um, there are more long
Speaker 1: words for all of those things, which right now there's
Speaker 1: there's a tachycardia there you go, yeah, and breda cardia. Yes,
Speaker 1: so those are the too so breda cardias if it's
Speaker 1: beating too slowly, and tachycardia is when it's too quickly. Sure,
Speaker 1: there's also other conditions that can that can wrap up
Speaker 1: into needing a pacemaker a k A. M. Atrial fibrilation
Speaker 1: in which the upper chambers of the heart kind of
Speaker 1: quiver instead of really contracting. Yeah. So, in order for
Speaker 1: you to really understand what we're talking about here, the
Speaker 1: heart is divided up into four chambers right right, the
Speaker 1: left and right atria, which are the upper chambers, and
Speaker 1: the left and right ventricles, which are the lower chambers. Right,
Speaker 1: So the upper chamber chambers, the atria, when they when
Speaker 1: they contract, they force blood down into the ventricles, which
Speaker 1: then when they can try to force it throughout the
Speaker 1: rest of the body. And so the combination of these
Speaker 1: two contractions are what we think of the heartbeat. The
Speaker 1: whole love dub dub is that. Yeah, So that's you know,
Speaker 1: the love the atria and the dub the ventricles, so
Speaker 1: you know that there's just plenty of room for romance.
Speaker 1: But so if if one of these is not working
Speaker 1: out correctly, then it's it's a huge problem. Right. So,
Speaker 1: if the atria are doing this fibrillation where they are
Speaker 1: quivering instead of beating, then it's not providing the right
Speaker 1: amount of blood to the ventricles to pump it through
Speaker 1: the rest of the body. That's all obviously an issue,
Speaker 1: but there's another one too. Write there's also heart block,
Speaker 1: in which the electrical signal is slowed or disrupted as
Speaker 1: it moves through the heart. So again the problem with
Speaker 1: actually the signal reaching the place where it needs to
Speaker 1: go so that you have a healthy heartbeat. Right. It's
Speaker 1: it's like if the cover on your wire is a
Speaker 1: little bit screwy something something to that extent, except the
Speaker 1: wires your heart and you need that wire pretty badly. Yeah,
Speaker 1: it's it's um. Unless you're the tin man, you pretty
Speaker 1: much need one. And these conditions can be caused by
Speaker 1: all kinds of disease and other wackiness that could be.
Speaker 1: It could be an inherited condition, it can be after
Speaker 1: a heart attack, if if a heart attack damages the muscle, right, yeah,
Speaker 1: there are injuries that can end up injuring the heart
Speaker 1: as a as a result. Yeah. So there's lots of
Speaker 1: different ways that this could happen, including things like just
Speaker 1: coming out of a surgery that's unrelated to your heart. Sure, absolutely, Okay,
Speaker 1: So so what happens when your heart lacks rhythm? You
Speaker 1: can no longer do really crazy dances like the electric slide. Okay,
Speaker 1: true enough. However, it mostly means that your body might
Speaker 1: not be getting enough blood, which would cause a tiredness, lightheadedness,
Speaker 1: breathlessness even like fainting, organ damage, and and can potentially
Speaker 1: even lead to death if it goes unchecked. Yeah. Yeah,
Speaker 1: so we're talking about very serious stuff. Now. A healthy
Speaker 1: adult has a heart rate at rest. That's what between
Speaker 1: sixty beats permant something like that. Ye ye, so um,
Speaker 1: mind's on the high end, which is actually not great.
Speaker 1: It means that, honestly, that Jonathan needs to exercise more
Speaker 1: so that I have a healthier cardio life. And that's
Speaker 1: something that I am working on because it's a concern, right,
Speaker 1: I'm getting I'm getting to a certain age um physically
Speaker 1: if not mentally or emotionally, so I need to prepare
Speaker 1: for that. Generally, slower heartbeat within that range is is ideal.
Speaker 1: Um and healthy heartbeats are regular because we have, like
Speaker 1: I said earlier, those built in pacemakers. Those are the
Speaker 1: sino ar trial I said that right, Yes, which at
Speaker 1: the at the at the upper right. Okay, gotcha. So yeah,
Speaker 1: so it's this is kind of the signal that lets
Speaker 1: the atria no to to contract. So once that signal
Speaker 1: goes through to contract the atria, what happens then, Like,
Speaker 1: how is it then move onto the ventricle um, it
Speaker 1: passes through another node, the atrio ventricular nod. Well, yeah, okay, cool.
Speaker 1: So you've got two nodes that are doing this and
Speaker 1: they're doing it in a very precise rhythm so that
Speaker 1: it creates this contraction that that then pumps the blood
Speaker 1: through the rest of the body. All right, And if
Speaker 1: that's atrial node isn't working properly, the atrio ventricular node
Speaker 1: can take over for it. But it's a it's it's
Speaker 1: a weaker force, so it's not as efficient, it's not
Speaker 1: as efficient. It's only going to get you up to
Speaker 1: about forty beats per minute. Which, um, is why you're
Speaker 1: going to encounter that fatigue and breathlessness and stuff like that. Right,
Speaker 1: So you'll you'll you'll live, but you'll be getting an
Speaker 1: increasingly poor condition. Um. So what do pacemakers do. Pacemakers
Speaker 1: can can regulate that they can help slow the rhythm
Speaker 1: of a too fast heartbeat or help control and a
Speaker 1: regular or too fast form or too slow them. So
Speaker 1: they can they can monitor the impulses and override it
Speaker 1: or pulses, I guess I should say, and override it
Speaker 1: so that it has a more regular heartbeat and keep
Speaker 1: someone at an optimal heartbeat range. Right. Sure, And and
Speaker 1: if those if those two nodes are not communicating properly,
Speaker 1: a pacemaker can help coordinate the electrical signals between them.
Speaker 1: I see. So if maybe the cino ore atrial nodes
Speaker 1: working just fine, but perhaps the ventricular ones not, then
Speaker 1: this could help balance that balance that out right? Sure?
Speaker 1: And it does this because okay, So, so a pacemaker
Speaker 1: is essentially a very small generator hooked up to a
Speaker 1: battery and a computer. Again, very small battery and very
Speaker 1: small computer. You have to be implant the sure um
Speaker 1: and wires are threaded from the pacemaker through a vein
Speaker 1: to the heart. Um. Those wires being tipped with electrodes,
Speaker 1: and the electrodes detect your heart's electrical activity and rhythm
Speaker 1: and then send that information to the computer which will
Speaker 1: monitor them. Um and then uh, it will direct the
Speaker 1: generator to fire whenever the signals go go wnkey all right.
Speaker 1: So what the computer is doing is looking for any irregularities,
Speaker 1: share addresses that right. Um. It can also record these
Speaker 1: signals for your doctor to upload and used to adjust
Speaker 1: your pacemaker. Um using a wireless device. They don't have
Speaker 1: to do surgery on you and check it because they
Speaker 1: want to check it about quarterly, so that would be messy.
Speaker 1: So this is kind of like a very important version
Speaker 1: of a physical activity tracker. It's keeping data on the
Speaker 1: activity of your heart and let your doctor know exactly
Speaker 1: what's going on right right um. In some cases, that
Speaker 1: onboard computer can even be accessed remotely via the interwebs.
Speaker 1: So for those of you who are privacy worried about
Speaker 1: that kind of thing, the idea that your heart rate
Speaker 1: is being monitored remotely maybe not for you. I actually
Speaker 1: think I actually think it's super awesome, Like the idea
Speaker 1: that that a doctor would have that level of granular
Speaker 1: information about a pay stients health and and even be
Speaker 1: able to preemptively tell the patient, hey, I'm detecting some
Speaker 1: unusual readings here. Could you come in so that we
Speaker 1: can make sure that you are in good shape, that
Speaker 1: you're in good shape, and that it's not an equipment malfunction.
Speaker 1: And you know, obviously that would be incredibly important. And
Speaker 1: if it were, you know, I mean there's some some
Speaker 1: people have pacemakers who are who are basically doing okay,
Speaker 1: it's more precautionary, and but there are other very life
Speaker 1: threatening ventricular diseases. Sure, sure, yeah, some models, called great
Speaker 1: responsive models will actually adjust to your heart rate to
Speaker 1: your changes in activity. Gotcha is like, which again makes sense.
Speaker 1: For example, like if you're exerting yourself, then you might
Speaker 1: need a different heart rate than if you were at rest.
Speaker 1: And uh that's why I remember older pacemakers that was
Speaker 1: a real challenge because they would they would keep a
Speaker 1: very steady heart rate, which was great, but if you
Speaker 1: break into a brisk jug your heart wouldn't be able
Speaker 1: to to keep up when the in the computer would
Speaker 1: start misfire. Right, So that was a real issue. Sure sure, so, um,
Speaker 1: So there are three basic types of pacemakers. You've got
Speaker 1: single chamber which carry impulses from the generator to the
Speaker 1: heart's right ventricle. Dual chamber which carry those impulses to
Speaker 1: the right ventricle and the right atrium um and and
Speaker 1: also helped coordinate the timing between the two. Then you've
Speaker 1: got bi ventricular which which carry those impulses to the
Speaker 1: right atrium and both ventricles helping coordinate all of the signals.
Speaker 1: And uh, those are yeah for for as you can imagine,
Speaker 1: those those are increasing in seriousness right right, obviously because
Speaker 1: you're talking about having to take over more and more
Speaker 1: of the hearts activity. There are all there are also
Speaker 1: related UM implantable cardio verter cardioverter did I say that right? Yes,
Speaker 1: implantable cardioverter defibrillators, which UM use not only those low
Speaker 1: energy impulses that a regular pacemaker would use, but also
Speaker 1: UM high high energy impulses when necessary to treat very
Speaker 1: life threatening So like if you're for example, there I'll
Speaker 1: t talk about some of the early ones of this,
Speaker 1: but there are some devices that let's say the detects
Speaker 1: at your heart that maybe you're going into cardiac arrest.
Speaker 1: It can actually deliver a strong enough electrical impulse to possibly,
Speaker 1: you know, kickstart your heart going again. So it ends
Speaker 1: up being like you know, if you guys have ever
Speaker 1: seen any medical procedural, you have obviously seen the person
Speaker 1: with which they usually use incorrectly. Yeah, the clear part
Speaker 1: is important, by the way, Yes, but now he's doing
Speaker 1: poorly from too much electric Um. Yeah, that's ah. This
Speaker 1: is something that's sort of an implantable device that does
Speaker 1: a similar thing, although it does it in a very
Speaker 1: precise way because it's delivering it directly to the heart
Speaker 1: and um and and not every pacemaker does this. Um.
Speaker 1: They can also, like Jonathan said earlier, be temporary if
Speaker 1: you've just had if you've just had a heart attack
Speaker 1: or surgery, or perhaps overdosed. While while the patient is
Speaker 1: in the hospital with these kinds of issues, they might
Speaker 1: have a temporary pacemaker. UM. And of course the permanent ones,
Speaker 1: which is more what we've been talking about. I mean,
Speaker 1: they wouldn't implant a temporary one, right, Yeah. In fact,
Speaker 1: the earliest pacemakers are more like what you would see
Speaker 1: with a temporary pacemaker, I mean, far the temporary ones
Speaker 1: that we use now are far more sophisticated. Of course,
Speaker 1: orders of magnitude more sophisticated. But the ideas that you
Speaker 1: would have an external device that would be able, you know,
Speaker 1: anyone could monitor and also be able to like a
Speaker 1: medical professional would be able to disconnect it once that
Speaker 1: was a viable option, and wires would go into you,
Speaker 1: which is kind of, you know, depending upon your level
Speaker 1: of comfort, a little squeaky, but I'm honestly pretty squeaked
Speaker 1: out by the entire wire through a vein thing. Yeah. Well,
Speaker 1: just wait until we talk about the history of pacemakers,
Speaker 1: because it's going to get really interesting. I'm glad you
Speaker 1: took that research. So, in the case of permanent pacemakers,
Speaker 1: batteries and generators usually have to be replaced every five
Speaker 1: to fifteen years, usually about six or seven. It's really
Speaker 1: the battery start running down, and they figure, while we're
Speaker 1: performing surgery on you, we might as well change out
Speaker 1: the generator to make sure that it doesn't start running
Speaker 1: down to right right, So that way, and it actually
Speaker 1: decreases the number of surgeries you would need over the lifetime.
Speaker 1: Over your lifetime, right sure, yeah, the lifetime of the product,
Speaker 1: your lifetime, um and the wires may eventually need to
Speaker 1: be replaced as well, but that's that's more case to
Speaker 1: case basis. Right now, we talked about in our Electronics
Speaker 1: and f A a episode about electromagnetic interference and even
Speaker 1: discussed a little bit about how people with pacemakers need
Speaker 1: to be careful around devices that emit E m I,
Speaker 1: which is pretty much anything that's electrical, right right, And
Speaker 1: that's because, like any electrical signal, the impulse is sent
Speaker 1: by pacemaker can be disrupted by an electromagnetic field. Yeah. So, now, granted,
Speaker 1: in most cases, the instructions you get are pretty pretty
Speaker 1: common sense, and stuff like don't don't lay down and
Speaker 1: put a laptop computer or a cell phone or for
Speaker 1: your heart. Yeah you don't wanna, don't wanna have like
Speaker 1: your cell phone in your shirt pocket for example, right right,
Speaker 1: You know, avoid brushing up next to strong household appliances,
Speaker 1: industrial welders. Don't lay directly against the microwave as you
Speaker 1: wait for that sweet sweet popcorn to be delivered to
Speaker 1: your hands. You know, keep keep it. Keep your generators.
Speaker 1: You're you're larger than your heart generator generator at arms
Speaker 1: length that don't use jackhammers kind of that kind of
Speaker 1: I never do and everyone thanks me. Yeah, so's and
Speaker 1: you know, I mean, things like metal detectors are are
Speaker 1: fine if they're you know, I it's you're supposed to
Speaker 1: tell security agents like, hey, I've got this pacemaker thing,
Speaker 1: please kill me, and and they will know how to
Speaker 1: deal with that. Yeah. So it's it's certainly one of
Speaker 1: those things that does mean, you know, you have to
Speaker 1: take that into account in your lifestyle. Sure, but it's
Speaker 1: also development that has, like we said, given a huge
Speaker 1: number of people a chance at a healthy life that
Speaker 1: otherwise they would not have. So it's it's phenomenal technology.
Speaker 1: We'll talk more about how we developed this technology over
Speaker 1: years and years of experimentation, some of which enters into
Speaker 1: the Frankenstein Mad Scientist realm. And I can't wait to
Speaker 1: talk about it. But before we do, let's take a
Speaker 1: quick break to thank our sponsor. Now let's get back
Speaker 1: to talking about pacemakers. Now, in this particular episode, we
Speaker 1: kind of divided up the research of it, so Lauren
Speaker 1: ended up looking a lot at how the heart works
Speaker 1: and how pacemakers tend to work. If you guys have
Speaker 1: ever listened to for thinking, you know that I am
Speaker 1: the medical correspondent. Yeah. Yeah, we we make her look
Speaker 1: at all the squeaky stuff so we don't have to
Speaker 1: because she likes squeaky stuff like um. Although slime, I
Speaker 1: would slime is really great, guys. Although I would I
Speaker 1: would argue glancing through your notes here for the history
Speaker 1: that you actually got the short end of the squick stage.
Speaker 1: You know what. This This is why never used the
Speaker 1: phrase quick stick. This is a This is entering into
Speaker 1: a realm that I actually relish, I because we're talking
Speaker 1: about a realm of scientific exploration that definitely goes on
Speaker 1: that mad scientist side of the scale. I mean, in
Speaker 1: that really cool kind of Victorian era. And this this
Speaker 1: is the same era where we saw things like Mary
Speaker 1: Shelley's Frankenstein be published, and so that's you know, and
Speaker 1: and some of the stuff that was being talked about
Speaker 1: and discovered at this time plays into the narrative of
Speaker 1: that story, although in a much more kind of literary
Speaker 1: way and not a scientific way. But at any rate,
Speaker 1: this is when we had people really thinking about electricity
Speaker 1: and its effect on the human body, and not just
Speaker 1: the human body as it turns out, So you really
Speaker 1: need to talk about the history of the pacemaker have
Speaker 1: to go all the way back to the mid seventeen hundreds.
Speaker 1: That's when it's when people started to experiment with what
Speaker 1: they called electro stimulation, using electricity to stimulate muscles. Uh.
Speaker 1: And in fact, by this time they were looking at
Speaker 1: cardiac electro stimulation, so again using electricity to stimulate the heart.
Speaker 1: This was all in animals at the time. Yeah, So
Speaker 1: they would find recently dead animals, or they would make
Speaker 1: an animal recently dead, and then they would use some
Speaker 1: form of electricity to use on electricity source to stimulate
Speaker 1: the animal's heart. Electric sources. Yeah, at the time, they
Speaker 1: had they had laden jars and voltaic piles peels Actually
Speaker 1: you should say voltaic peels. It's it's actually named uh
Speaker 1: it's yeah, so peel is French, but it's voltaic peels
Speaker 1: or piles if you prefer both of which we were.
Speaker 1: I mean our batteries. They are viable batteries, but very dangerous, yeah,
Speaker 1: and not particularly strong unless you make huge stacks. Right.
Speaker 1: So these are predecessors to what we consider the modern battery.
Speaker 1: But that was when there was a lot of experimentation
Speaker 1: going on. So they would use them to stimulate the
Speaker 1: cardiac nerves and animals in an attempt to resuscitate intact
Speaker 1: dead animals and thus, as my notes say, infect the
Speaker 1: world with chipmunk zombies. Uh. So, there was a fellow
Speaker 1: named Luigi Galvani who was credited with proposing electricity as
Speaker 1: the mechanism that causes our muscles to operate. Now here's
Speaker 1: the story. Uh, this is very possibly apocryphal, but the
Speaker 1: the story the legend that Galvani was working on on
Speaker 1: dissecting a little froggy and uh ended up building up
Speaker 1: an electrostatic charge and picked up a scalpel and touched
Speaker 1: the scalpel to the froggy and it discharged the electro
Speaker 1: static charge, which created the spark and made the froggy's
Speaker 1: leg twitch. Thus, Galvanni began to think of electricity as
Speaker 1: being the means through which our muscles operate. He called
Speaker 1: it animal electricity, as opposed to what was being called
Speaker 1: heat electricity. So he's he thought that animal electricity was
Speaker 1: some sort of electricity trical type of fluid that would
Speaker 1: make muscles move. Before then, it was this idea of
Speaker 1: laden jars were still based on the principle that electricity
Speaker 1: was a fluid isn't that correct? Yeah, yeah, so we're
Speaker 1: you know, this is obviously this is the early days
Speaker 1: of learning about electricity. So uh. At any rate that
Speaker 1: that research led other people to start to tinker around.
Speaker 1: One of those was William Hawes h A W. E. S.
Speaker 1: He established a society in London called the Humane Society.
Speaker 1: But it's not the Humane Society the way we would
Speaker 1: think of it in the United States. You hear the
Speaker 1: Humane Society and you think, oh, that's an animal rescue.
Speaker 1: It's not for adopting dogs and cats. Know, this was
Speaker 1: a a group that was dedicated to um well, salvaging
Speaker 1: people who appeared to be dead. This was a big
Speaker 1: concern at the time a lot of people. You know,
Speaker 1: we didn't really have the more precise scientific definitions and
Speaker 1: even today's debatable of of what is alive and what
Speaker 1: is dead, and we you know, we didn't have heart
Speaker 1: rate monitors. It was a morbid time, really, it's what
Speaker 1: it was. It was a lot harder to tell and
Speaker 1: so there was a huge fear of getting buried alive. Yeah.
Speaker 1: So there was also a similar society at the time
Speaker 1: in Paris. Paris, Uh, I assume Paris friends and not Paris, Texas.
Speaker 1: Eventually the organization would become the Royal Humane Society of London,
Speaker 1: and very early on during this society's days, scientists began
Speaker 1: to explore electro stimulation as a way of resuscitating people
Speaker 1: who appear to have died and maybe who are not
Speaker 1: actually dead but could be revived. So se A guy
Speaker 1: named Charles Kite writes uh paper titled an Essay upon
Speaker 1: the Recovery of the Apparently Dead, which is already my
Speaker 1: favorite title of a of a paper since uh, since
Speaker 1: more wrote Cramming more components on integrated circuits. Um, I love,
Speaker 1: I love, I love these titles. They're better. That's the
Speaker 1: best kind of research, really. So, according to the essay,
Speaker 1: Ki used electro stimulation to treat a three year old child.
Speaker 1: She had fallen out of a window and appeared to
Speaker 1: be dead. They had called in an apothecary, who was
Speaker 1: unable to do anything. Kite said that it was twenty
Speaker 1: minutes before he could arrive to provide some sort of
Speaker 1: electro stimulation to the child's heart. He used his He
Speaker 1: used essentially electrodes to to deliver a gentle electrical shock
Speaker 1: to various parts of the child's body eventually setting on
Speaker 1: the thorax or chest really to uh and found that
Speaker 1: he got a pulse when he did that, and claimed
Speaker 1: that the child woke up was very groggy and uh
Speaker 1: and and confused about her surroundings, but that she eventually
Speaker 1: made a full recovery. What that tells me is that
Speaker 1: this story is probably either exaggerated or there are some
Speaker 1: big missing components, Because being dead for twenty minutes is
Speaker 1: being dead is dead. You're not You're not You're not
Speaker 1: bouncing back from that really, But any rate, it could
Speaker 1: be that that no one at the house at the
Speaker 1: time could find a heartbeat, right, could have been that
Speaker 1: she had a very weak pulse interminute pulse. Even so,
Speaker 1: at any rate, that's the story. From seventy six, a
Speaker 1: couple of Danish scientists published a paper that was titled
Speaker 1: Life Saving Measures for drowning persons and Information of the
Speaker 1: best means by which they can be brought back to life,
Speaker 1: and that also included electro stimulation of the heart as
Speaker 1: a means of saving people. We're gonna jump ahead, so
Speaker 1: a lot of people researching this. In eighteen twenty, Dr
Speaker 1: de Sanctus in The Medical Guide described the reanimation chair.
Speaker 1: I didn't show you a picture of this yet, have
Speaker 1: I learned? You're gonna get a chance to see it
Speaker 1: on social as well. The chair included bellows which were
Speaker 1: meant to force air into the person's lungs, a metallic
Speaker 1: tube inserted into the person's esophagus, and a voltaic peel
Speaker 1: or pile, depending upon how you want to pronounce it,
Speaker 1: attached at one end of the metal tube and the
Speaker 1: other end was to an electrode. The electrode was then
Speaker 1: to quote regions of the heart, the diaphragm, and the
Speaker 1: stomach end quote to cause muscles to contract. If you
Speaker 1: look at this thing, or illustrations of this thing, I
Speaker 1: should say I haven't seen a picture of what I
Speaker 1: don't know if one was ever actually built, but the
Speaker 1: illustrations of what it was supposed to look like look
Speaker 1: like it came from Hostile or Saw or one of
Speaker 1: those movies. It is absolutely terrified to behold. It makes
Speaker 1: a dentist chair look absolutely comforting by by comparison, I
Speaker 1: look forward to it. Yeah, experiments with electro puncture, this
Speaker 1: is where we're really getting into the fun stuff. So
Speaker 1: that is that is combining electrical stimulation with acupuncture. So
Speaker 1: you've got a needle that you insert into the body
Speaker 1: of your your subject and then you shoot electricity through
Speaker 1: it to stimulate. Yeah, well animal, it was most animals,
Speaker 1: mostly dogs. Actually, uh yeah, I didn't want to dwell
Speaker 1: on that too much because I love my doggies. So anyway,
Speaker 1: it turned out the early experiments anyway, it turned out
Speaker 1: to be i'll use the word failure, So no Frank
Speaker 1: and doggies. From this particular early experimentation, however, other people
Speaker 1: would start to experiment with using insulated needles that could
Speaker 1: deliver an electrical shock to a specific point, the point
Speaker 1: of the needle in fact, and that would in fact
Speaker 1: be the basis for early pacemakers. Uh. They did discover
Speaker 1: that by refining this process that they could stimulate activity
Speaker 1: in a heart that was undergoing cardiac arrest. And again
Speaker 1: they were using animals, and essentially, in order to experiment,
Speaker 1: they would over a neesthetize animals in or to induce
Speaker 1: cardiac arrest. So we would see more and more experiments
Speaker 1: between eighteen twenty eight and nineteen thirty, which is the
Speaker 1: next date I have on my my list, and I I
Speaker 1: don't want to be too exhaustive with this, and also
Speaker 1: and they get pretty weird. And uh yeah, when you
Speaker 1: start talking about getting cadavers from recent executions, it starts
Speaker 1: to get pretty grim. So I'm going to I'm gonna
Speaker 1: skip over that. We skip over the entire Victorian era.
Speaker 1: We skip over Jack the Ripper. Uh, listen to stuff
Speaker 1: you missed in history class. They cover all that kind
Speaker 1: of stuff. All right, it's n That's when a fellow
Speaker 1: by name of Albert S. Hyman develops and patents the
Speaker 1: artificial pacemaker. Yeah, so this thing did not look like
Speaker 1: a pacemaker as you and I would would recognize if
Speaker 1: we were to see one, which are which are large
Speaker 1: coin sized. Yeah, they're they're in the Grand Scheme of
Speaker 1: Medical Devices. They are tiny. Uh, this one was not tiny.
Speaker 1: This was a hand crank. Okay, So you had a
Speaker 1: hand crank and it had wires cables essentially that ended
Speaker 1: in needles that could be inserted into a person and
Speaker 1: by turning the hand crank. There was also a spring
Speaker 1: motor inside of it that turned a magneto, which is
Speaker 1: a d C current generator. So essentially what you're doing
Speaker 1: is you're turning We've talked about inducing electricity to flow
Speaker 1: by using moving a conductor through a fluctuating magnetic field.
Speaker 1: This is a way of doing that by hand. You
Speaker 1: turn the cranks. It's turning it through this magnetic field.
Speaker 1: That's inducing electricity to throw to flow rather and that
Speaker 1: ends up supplying the electricity needed for the pacemaker. The
Speaker 1: insulation needle would deliver the electric charge to the right
Speaker 1: atrium of the heart, and by March first, nineteen thirty two,
Speaker 1: the pacemaker had been used forty three times with a
Speaker 1: successful outcome in fourteen cases, which is about a thirty
Speaker 1: three percent success rate, which sounds incredibly low, but then
Speaker 1: keep in mind that the essentially this was an absolute
Speaker 1: last Yeah, this was the last last ditch effort to
Speaker 1: try and revive someone. So it wasn't like this what
Speaker 1: These were not the type of pacemakers we've talked about
Speaker 1: in our episode where we talked about the things that
Speaker 1: you would have in your in your chest for a
Speaker 1: prolonged period. This was really meant to revive someone. Yeah,
Speaker 1: so this is this is a little different thing. Patient
Speaker 1: saved is actually better and zero percent. So, uh, nineteen forties,
Speaker 1: that's when they started to Engineers and doctors began to
Speaker 1: work on designing defibrillators, which, as we said, can play
Speaker 1: a part in some types of pacemakers that you can
Speaker 1: find today that are it's kind of a combination device really.
Speaker 1: Nine an elderly man who in the literature is called
Speaker 1: h N. They don't obviously identify people because it's medical,
Speaker 1: but h N suffered heart ailments for several years, had
Speaker 1: had heart attacks and other irregularities, and became the recipient
Speaker 1: of atronic products. Nine O two M battery operated pacemaker.
Speaker 1: This was not an internal unit. It was not an
Speaker 1: implant in that sense. They did implant the electrodes so
Speaker 1: that they had contact with the heart, but the cables
Speaker 1: to the actual device were external, and you would, you know,
Speaker 1: have to carry the pacemaker around with you and it
Speaker 1: was held outside the body. You know. It could also
Speaker 1: detect spont aneas cardiac activity. It had essentially had the
Speaker 1: ability to tell if something was going wrong. It wasn't
Speaker 1: necessarily able to respond to that dynamically, but it could
Speaker 1: at least warn a caregiver that something something was happening. Um,
Speaker 1: everything was it was, It worked all right. The one
Speaker 1: problem was that the area where the electrodes would go
Speaker 1: in through the skin Essentially the needle would go in
Speaker 1: through the skin um was prone to minor infections. There
Speaker 1: was never like that you would expect from from I mean,
Speaker 1: and that's part of the reason why the drive should
Speaker 1: create implantable rightmakers exist. And we talked about, you know,
Speaker 1: the fact that in our piercing episode or our body
Speaker 1: modification episode, we talked about that there is a a
Speaker 1: possibility of developing these kind of infections and they may
Speaker 1: not be serious, it may not be life threatening, but
Speaker 1: they can be problematic. And that was exactly what he
Speaker 1: had experienced. It wasn't an infection that was developing into sepsis,
Speaker 1: but it was like he would have to have the
Speaker 1: area ened regularly so that he could clear out any infection. UH.
Speaker 1: In late nineteen sixty two, he underwent surgery for a
Speaker 1: pacemaker implant, but he never fully recovered. In fact, he
Speaker 1: never recovered from the surgical procedure. He died twenty days
Speaker 1: after the surgical procedure, So that was an unfortunate tragedy there,
Speaker 1: but he did have lived for several years with this
Speaker 1: external pacemaker. In nineteen sixty doctor Robert Rubio implant a
Speaker 1: pacemaker into a female patient and that pacemaker was fifty
Speaker 1: two point five millimeters in diameter, which is about two
Speaker 1: inches uh seventeen point five millimeters thick, which is about
Speaker 1: point seven inches, so just over half an inch, and
Speaker 1: waged sixty four point three grams or two point three
Speaker 1: ounces or less than a quarter of a pound. Now
Speaker 1: that one got power from two rechargeable nickel cadmium batteries
Speaker 1: which were charged through induction from an external flexible coil
Speaker 1: placed on the skin over the pacemaker. So this is
Speaker 1: the way some pacemakers are recharged today using a similar approach,
Speaker 1: although it's usually radio frequencies. But what we're talking about
Speaker 1: wireless power here right where you can induce this charging
Speaker 1: through um again, your your cree. It's all about magnetic
Speaker 1: fields and electricity is really what we get down to.
Speaker 1: So you would have to place this flexible coil directly
Speaker 1: over your heart in order to recharge the pacemaker, or
Speaker 1: really directly over the pacemaker wherever the pacemaker was located,
Speaker 1: wherever the you know, the battery was uh. The stimulated
Speaker 1: electrode for this was a platinum disk, so it was
Speaker 1: an expensive piece of medical technology. But sadly the patient
Speaker 1: died nine and a half months after the surgery, because
Speaker 1: she did develop an infection which turned into sepsis after
Speaker 1: the surgery. So the pacemaker was working, but the it
Speaker 1: was a side effect of the surgery. She unfortunately perished
Speaker 1: from that. So early implannable pacemakers varied widely and how
Speaker 1: long they could operate before requiring a recharge. So one
Speaker 1: of them would only go like eight hours and then
Speaker 1: you have to recharge it. That's pretty yeah, that's pretty yeah.
Speaker 1: But there were others that could go weeks or even
Speaker 1: months before a recharge, even in the early days in
Speaker 1: the sixties. Uh this this also, I mean still today,
Speaker 1: how much how much your your pacemaker is actually needing
Speaker 1: to to create a charge will make your battery life
Speaker 1: very right. So in other words, in other words, if
Speaker 1: if it's only occasionally having to intervene, then you're recharging,
Speaker 1: may you may not need to recharge it as frequently
Speaker 1: as someone where it's more active more frequently. Um So,
Speaker 1: in the nineteen sixties, that's when we started to see
Speaker 1: the cardiac stimulator defibrillators, which we kind of talked about.
Speaker 1: It's under called something else today, but same sort of
Speaker 1: idea that the device that can uh detect when a
Speaker 1: heart beat stops and then try to restart it with
Speaker 1: a controlled electrical burst to the heart. Uh. The early
Speaker 1: versions of that were also not implantable. They were external
Speaker 1: as well. But now we've got implantable ones that are
Speaker 1: incorporated with sort of pacemaker technology. UM. Now, as far
Speaker 1: as the future goes, because from the nineteen sixties on
Speaker 1: to the present, it was really refining that process. It's
Speaker 1: just that miniaturization and in electrical stimulation yep, yep, making
Speaker 1: sure that we were getting more precise and smaller. Those
Speaker 1: are really the trends. So anything from nineteen sixties on
Speaker 1: is more about refining that that design. Uh. Talking about
Speaker 1: the future, miniaturization is going to continue to be a factor.
Speaker 1: In fact, there are companies right now that are trying
Speaker 1: to create pacemakers that are about the size of a pill.
Speaker 1: So that tiny. So the reason why you want this
Speaker 1: is not just because it it takes up less space
Speaker 1: in the patient. Really, it's because the surgical procedures become
Speaker 1: less invasive. It's less damaged to the body, less chance
Speaker 1: for infection, UH, makes it less chance for something to
Speaker 1: go wrong, because you're it's just it's just a smaller
Speaker 1: surgical procedure. So that's really where we're seeing the future
Speaker 1: come in as far as Pacemakers are concerned. And now
Speaker 1: that kind of wraps up our our episode. We were
Speaker 1: really interested in this topic. It was kind of it's
Speaker 1: it's always fun for us to take a specific technology
Speaker 1: and explain how it works and really where it came from.
Speaker 1: We love doing that. I mean we obviously we love
Speaker 1: doing things like covering various companies as well. Uh, not
Speaker 1: to mention the fact that we have covered many, many,
Speaker 1: many personalities in technology. But if you guys want to
Speaker 1: hear us do more of this sort of thing, then
Speaker 1: I recommend you right in and let us know. So
Speaker 1: send us a message. You can write us an email
Speaker 1: that addresses tech stuff at Discovery dot com, where you
Speaker 1: can find us on Tumbler or Facebook or Twitter with
Speaker 1: the handle text stuff hs W and who knows, you know,
Speaker 1: we may take your your suggestion. This suggestion, by the way,
Speaker 1: came to us from a listener right Facebook, from Peter. So, Peter,
Speaker 1: I hope you enjoyed this episode about Pacemakers. I hope
Speaker 1: you were not asking about Jerry and the Pacemakers, because
Speaker 1: that's a band and they did very Across the Mercy,
Speaker 1: which is a great song but not what we covered.
Speaker 1: So hopefully we met your expectations. Let us know if
Speaker 1: we didn't. And guys, that wraps this up. We will
Speaker 1: talk to you again really soon for more on this
Speaker 1: and thousands of other topics. Is it how stuff works
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