Speaker 1: Welcome to tech Stuff, a production from I Heart Radio.
Speaker 1: Hey there, and welcome to tech Stuff. I'm your host,
Speaker 1: Jonathan Strickland. I'm an executive producer with I Heart Radio
Speaker 1: and I love all things tech. And it is time
Speaker 1: once again, my friends, for a classic episode, and this
Speaker 1: one published on October ninth, two thousand thirteen. It is
Speaker 1: titled Pacemakers Got the Beat. This just reminds me of
Speaker 1: how much work I put into making really really cringe
Speaker 1: e titles back in the day. I still do it occasionally,
Speaker 1: but man, I was really on a role in two
Speaker 1: thousand thirteen. Let's listen in to this classic episode. 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 divice is that are
Speaker 1: implanted nearish the heart in the general just air, cavity, shoulder,
Speaker 1: abdomen somewhere on there. They use low energy electrical impulses
Speaker 1: to help control any abnormal heart rhythms um sometimes called
Speaker 1: rhythmias rhythmia. Thank you. I had an arrhythmia as a child,
Speaker 1: did you Yeah, I had a arrhythmia and a heart murmur. Wow,
Speaker 1: that's exciting in the bad way. So anyway, so those
Speaker 1: 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, there's there's
Speaker 1: a tachycardia there you go, yeah, and breda cardia. Yes,
Speaker 1: so those are the too so brada 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. Atrial fibrilation in
Speaker 1: which the upper chambers of the heart kind of quiver
Speaker 1: instead of really contracting. Yeah. So, in order for you
Speaker 1: to really understand what we're talking about here, the heart
Speaker 1: is divided up into four chambers right right, the left
Speaker 1: and right atria, which are the upper chambers, and the
Speaker 1: 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 if one of these is not
Speaker 1: working out correctly, then it's huge problem. Right. So, if
Speaker 1: the atria are doing this fibrillation where they are quivering
Speaker 1: instead of beating, then it's not providing the right amount
Speaker 1: of blood to the ventricles to pump it through the
Speaker 1: rest of the body. That's all obviously an issue, but
Speaker 1: there's another one to write. There's also heart block, in
Speaker 1: which the electrical signal is slowed or disrupted as it
Speaker 1: moves through the heart. So again problem with actually the
Speaker 1: signal reaching the place where it needs to go so
Speaker 1: that you have a healthy heartbeat. Right. It's it's like
Speaker 1: if the cover on your wire is a little bit
Speaker 1: screwy something something to that extent, except the wires your
Speaker 1: heart and you need that wire pretty badly. Yeah, and
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, So,
Speaker 1: so what happens when your heart lacks rhythm? You can
Speaker 1: 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. Yep, yep. 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
Speaker 1: ideal um and healthy heartbeats are regular because we have,
Speaker 1: like I said earlier, those built in pacemakers. Those are
Speaker 1: the sino artrial I said that, right, Yes, the nodes
Speaker 1: which the at the at the upper right. Okay, gotcha.
Speaker 1: So yeah, so it's this is kind of the signal
Speaker 1: that lets the atria no to to contract. So once
Speaker 1: that signal 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 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. Right, And if that's
Speaker 1: you know, atrial node isn't working properly, the atrio ventricular
Speaker 1: node can take over for it, but it's a it's
Speaker 1: it's a weaker force so it's not as efficient. It's
Speaker 1: not as efficient. It's only going to get you up
Speaker 1: to about forty beats per minute, which, um, is why
Speaker 1: you're going to encounter that fatigue and breathlessness and stuff
Speaker 1: like that. Right, So you'll you'll you'll live, but you'll
Speaker 1: be getting an increasingly poor condition. Right, Um, So what
Speaker 1: do pacemakers do. Pacemakers can can regulate that they can
Speaker 1: help slow the rhythm of a too fast heartbeat or
Speaker 1: help control and a regular too fast rhythm or too
Speaker 1: slow rhythm. So they can they can monitor the impulses
Speaker 1: and override it or pulses, I guess I should say,
Speaker 1: and override it so that it has a more regular
Speaker 1: heartbeat and keep someone at an optimal heartbeat range. Right. Sure,
Speaker 1: And and if those if those two nodes are not
Speaker 1: communicating properly, a pacemaker can help coordinate the electrical signals
Speaker 1: between them, I see. So if maybe the sino ore
Speaker 1: atrial nodes working just fine, but perhaps the ventricular ones not,
Speaker 1: then 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 implanted the implant, 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 wonkey, all right.
Speaker 1: So what the computer is doing is looking for any irregularities,
Speaker 1: addresses that right 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 letting 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 patient's health and and even be able
Speaker 1: to preemptively tell the patient, Hey, I'm detecting some unusual
Speaker 1: readings here. Could you come in so that we can
Speaker 1: make sure that you are in good shape. You're in
Speaker 1: good shape and that it's not an equipment malfunction. And
Speaker 1: you know, obviously that would be incredibly important. And if
Speaker 1: it were, you know, I mean there's some some people
Speaker 1: have pacemakers who are who are basically doing okay, it's
Speaker 1: more precautionary, and but there are other very life threatening
Speaker 1: ventricular diseases. Sure, sure, yeah, some models, called great responsive
Speaker 1: models will actually adjust to your heart rate to your
Speaker 1: 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 h 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 ask jog, your heart wouldn't be able
Speaker 1: to keep up when the and the computer would start misfiring.
Speaker 1: So that was a real issue. Sure, sure, So so
Speaker 1: there are three basic types of pacemakers. You've got single
Speaker 1: chamber which carry impulses from the generator to the heart's
Speaker 1: right ventricle, Dual chamber which carry those impulses to the
Speaker 1: right ventricle and the right atrium um and and also
Speaker 1: helped coordinate the timing between the two. And 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. They are all they're also related
Speaker 1: 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: end energy impulses that a regular pacemaker would use, but
Speaker 1: also UM higher high energy impulses when necessary to treat
Speaker 1: very life threatening So like if you're for example, there
Speaker 1: I'll talk about some of the early ones of this.
Speaker 1: But there are some devices that let's say the detects
Speaker 1: that 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 attacker,
Speaker 1: surgery or perhaps overdose. While while the patient is in
Speaker 1: the hospital with these kinds of issues, they might have
Speaker 1: 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 till we talk about the history of pacemakers,
Speaker 1: because that'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 generated as usually have to be replaced every
Speaker 1: five to fifteen years, usually about six or seven. It's
Speaker 1: really the batteries start running down, and they figure, while
Speaker 1: we're performing surgery on you, we might as well change
Speaker 1: out the generator to make sure that it doesn't start
Speaker 1: running down to right right, so that way, and it
Speaker 1: actually decreases the number of surgeries you would need over
Speaker 1: the lifetime, over your lifetime, right sure, yeah, the lifetime
Speaker 1: of the product, your lifetime. Um and the wires may
Speaker 1: eventually need to be replaced as well, but that's that's
Speaker 1: more case to case basis. Right now, we talked about
Speaker 1: in our Electronics and f A a episode about electromagnetic
Speaker 1: interference and even discussed a little bit about how people
Speaker 1: with pacemakers need to be careful around devices that emit
Speaker 1: E m I, which is pretty much anything that's electrical, right, right,
Speaker 1: And that's because like any electrical signal, the impulse is
Speaker 1: sent by pacemaker can be disrupted by an electromagnetic field. Yeah.
Speaker 1: So now, granted, in most cases, the instructions you get
Speaker 1: are pretty pretty common sense. Yeah, and stuff like don't
Speaker 1: don't lay down and put a laptop computer or a
Speaker 1: cell phone or for your heart. Yeah you don't wanna,
Speaker 1: don't wanna have like your cell phone in your shirt
Speaker 1: pocket for example, right right? You know, avoid brushing up
Speaker 1: next to strong household appliances, industrial welders. Don't lay directly
Speaker 1: against the microwave as you wait for that sweet sweet
Speaker 1: popcorn to be delivered to your hands. You know, keep
Speaker 1: keep it keep your generators. You're you're larger than your
Speaker 1: heart generator, generator at arm's length that don't use jackhammers
Speaker 1: kind of that kind of thing, never do and everyone
Speaker 1: thanks me. Yeah, So it's and you know, I mean,
Speaker 1: things like metal detectors are are fine if they're you know,
Speaker 1: I it's you're supposed to tell security agents like, hey,
Speaker 1: I've got this pacemaker thing, please don't kill me, and
Speaker 1: and they will know how to deal with that. Yeah.
Speaker 1: So it's it's certainly one of those things that does mean,
Speaker 1: you know, you have to take that into account in
Speaker 1: your lifestyle. Sure, but it's also development that has, like
Speaker 1: we said, given on a huge number of people a
Speaker 1: chance at a healthy life that otherwise they would not have. Hey, guys,
Speaker 1: it's Jonathan from twenty. We're going to take a break
Speaker 1: on this episode about pacemakers to thank our sponsors, but
Speaker 1: we'll be right back now. Let's get back to talking
Speaker 1: about pacemakers now. In this particular episode, we kind of
Speaker 1: divided up the research of it, so Lauren ended up
Speaker 1: looking a lot at how the heart works and how
Speaker 1: pacemakers tend to work. If you guys have ever listened
Speaker 1: to for thinking, you know, that I am the medical correspondent. Yeah,
Speaker 1: we we make her look at all the squeaky stuff
Speaker 1: so we don't have to because she likes squeaky stuff
Speaker 1: like um, although slime, I would slime is really great, guys.
Speaker 1: Although I would I would argue glancing through your notes
Speaker 1: here for the history that you actually got the short
Speaker 1: end of the squick stap. You know what. This This
Speaker 1: is why I never used the phrase quick stick. This
Speaker 1: is a this is entering into a realm that I
Speaker 1: actually relish. I because we're talking about a realm of
Speaker 1: scientific exploration that definitely goes on that mad scientist side
Speaker 1: of the scale. I mean, in that really cool kind
Speaker 1: of Victorian era. And this this is the same era
Speaker 1: where we saw things like Mary Shelley's Frankenstein be published,
Speaker 1: and so that's you know, and and some of the
Speaker 1: stuff that was being talked about and discovered at this
Speaker 1: time plays into the narrative of that story, although in
Speaker 1: a much more kind of literary way and not a
Speaker 1: scientific way. But at any rate, this is when we
Speaker 1: had people really thinking about electricity and its effect on
Speaker 1: the human body, and not just the human body as
Speaker 1: it turns out. So you really to talk about the
Speaker 1: history of the pacemaker, have to go all the way
Speaker 1: back to the mid seventeen hundreds. That's when when people
Speaker 1: started to experiment with what they called electro stimulation, using
Speaker 1: electricity to stimulate muscle. Uh. And in fact, by this
Speaker 1: time they were looking at cardiac electro stimulation, so again
Speaker 1: using electricity to stimulate the heart. This was all in
Speaker 1: animals at the time. Yeah, So they would find recently
Speaker 1: dead animals, or they would make an animal recently dead,
Speaker 1: and then they would use some form of electricity to
Speaker 1: use an electricity source to stimulate the animal's heart. Electric sources. Yeah,
Speaker 1: at the time, they had they had laden jars and
Speaker 1: voltaic piles peels actually you should say voltaic peels. It's
Speaker 1: it's actually named uh It's ok. Yeah, so peel is French,
Speaker 1: but it's voltaic peels or piles if you prefer both
Speaker 1: of which we were. I mean our batteries. They are
Speaker 1: viable batteries, but very dangerous, yeah, and not particularly strong
Speaker 1: unless you make huge stacks. Right. So these are predecessors
Speaker 1: to what we consider the modern battery. But that was
Speaker 1: when there was a lot of experimentation going on. So
Speaker 1: they would use to stimulate the cardiac nerves and animals
Speaker 1: in an attempt to resuscitate intact dead animals and thus,
Speaker 1: as my notes say, infect the world with chipmunk zombies. Uh. So,
Speaker 1: there was a fellow named Luigi Galvani who was credited
Speaker 1: with proposing electricity as the mechanism that causes our muscles
Speaker 1: to operate. Now here's the story. Uh, this is very
Speaker 1: possibly apocryphal, but the the story the legend that Galvani
Speaker 1: was working on on dissecting a little froggy and uh
Speaker 1: ended up building up an electrostatic charge and picked up
Speaker 1: a scalpel and touched the scalpel to the froggy and
Speaker 1: it discharged the electro static charge, which created the spark
Speaker 1: and made the froggy's leg twitch. Thus, Galvanni began to
Speaker 1: think of electricity as being the means through which our
Speaker 1: muscles operate. He called it animal electricity, as opposed to
Speaker 1: what was being called heat electricity. So he's he thought
Speaker 1: that animal electricity was some sort of electricity trickal type
Speaker 1: of fluid that would make muscles move. Before then, it
Speaker 1: was this idea of laden jars were still based on
Speaker 1: the principle that electricity was a fluid. Isn't that correct? Yeah, yeah,
Speaker 1: so we're you know, this is obviously this is the
Speaker 1: early days of learning about electricity. So at any rate
Speaker 1: that 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 that's an animal rescue. It's
Speaker 1: not for adopting dogs and cats. Know, this was a
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 this debatable of of what is alive and
Speaker 1: what is dead, and we you know, we didn't have
Speaker 1: heart rate monitors. It was a morbid time, really it was.
Speaker 1: It was a lot harder to tell and so there
Speaker 1: was a huge fear of getting buried alive. Yeah. So
Speaker 1: there was also a similar society at the time in Paris. Paris, uh,
Speaker 1: I assume Paris friends, not Paris, Texas. Eventually the organization
Speaker 1: would become the Royal Humane Society of London, and very
Speaker 1: early on during this society's days, scientists began to explore
Speaker 1: electro stimulation as a way of resuscitating people who appear
Speaker 1: to have died and maybe who are not actually dead
Speaker 1: but could be revived. So se A guy named Charles
Speaker 1: Kite writes uh paper titled an Essay upon the Recovery
Speaker 1: of the Apparently Dead, which is already my favorite title
Speaker 1: of a of a paper since uh since more wrote
Speaker 1: Cramming more components on integrated circuits. Um, I love, I love,
Speaker 1: I love these titles. They're better. That's the best kind
Speaker 1: of research. Drillly so. According to the essay, Kite used
Speaker 1: electro stimulation to treat a three year old child. She
Speaker 1: had fallen out of a window and appeared to be dead.
Speaker 1: They had called in an apothecary, who was unable to
Speaker 1: do anything. Kite said that it was twenty minutes before
Speaker 1: he could arrive to provide some sort of electro stimulation
Speaker 1: to the child's heart. He used his He used essentially
Speaker 1: electrodes to to deliver a gentle electrical shock to various
Speaker 1: parts of the child's body. Eventually settling on the thorax
Speaker 1: or chest really to uh and found that he got
Speaker 1: a pulse when he did that, and claimed that the
Speaker 1: child woke up was very groggy and uh and and
Speaker 1: confused about her surroundings, but that she eventually made a
Speaker 1: full recovery. What that tells me is that this story
Speaker 1: is probably either exaggerated or there are some big missing components,
Speaker 1: because being dead for twenty minutes is being dead. It
Speaker 1: is dead. You're not you're not bouncing back from that, really,
Speaker 1: But any rate, it could be that that no one
Speaker 1: at the house at the time could find a heartbeat, right,
Speaker 1: could have been that she had a very weak pulse
Speaker 1: interminute pulse. Even so, at any rate, that's the story
Speaker 1: from and See. A couple of Danish scientists published a
Speaker 1: paper that was titled life Saving Measures for drowning persons
Speaker 1: and Information of the best means by which they can
Speaker 1: be brought back to life, and that also included electric
Speaker 1: stimulation of the heart as a means of saving people.
Speaker 1: We're gonna jump ahead, so there a lot of people
Speaker 1: researching this. In eighteen twenty, Dr de Sanctus in The
Speaker 1: Medical Guide described the reanimation chair I didn't show you
Speaker 1: a picture of this yet, have I learned an You're
Speaker 1: gonna get a chance to see it. Link it on
Speaker 1: social as well. The chair included bellows which were meant
Speaker 1: to force air into the person's lungs, a metallic tube
Speaker 1: inserted into the person's esophagus, and a voltaic peel or pile,
Speaker 1: depending upon how you want to pronounce it, attached at
Speaker 1: one end of the metal tube and the other end
Speaker 1: was to an electrode. The electrode was then touched to
Speaker 1: quote regions of the heart, the diaphragm, and the stomach
Speaker 1: end quote to cause muscles to contract. If you look
Speaker 1: at this thing, or illustrations of this thing, I should
Speaker 1: say I haven't seen a picture of what I don't
Speaker 1: know if one was ever actually built, but the illustrations
Speaker 1: of what it was supposed to look like look like
Speaker 1: it came from Hostile or Saw or one of those movies.
Speaker 1: Is absolutely terrified to behold. It makes a dentist chair
Speaker 1: look absolutely comforting. By by comparison, it's Jonathan from Again.
Speaker 1: We're going to take another quick break from this classic episode,
Speaker 1: but we will return shortly. Experiments with electoral 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 Yeah, well animal probably it was mostly animals,
Speaker 1: mostly dogs. Actually, uh yeah, I didn't want to dwell
Speaker 1: on that too much because I'm I love my doggies.
Speaker 1: So anyway, it turned out the early experiments anyway, it
Speaker 1: turned out to be i'll use the word failure, So
Speaker 1: no Frank and doggies. From this particular early experimentation, however,
Speaker 1: other people would start to experiment with using insulated needles
Speaker 1: that could deliver an electrical shock to specific to a
Speaker 1: specific point, the point of the needle in fact, and
Speaker 1: that would in fact be the basis for early pacemakers. Uh.
Speaker 1: They did discover that by refining this process that they
Speaker 1: could stimulate activity in a heart that was undergoing cardiac arrest.
Speaker 1: And again they were using animals, and essentially, in order
Speaker 1: to experiment, they would over anesthetize animals in or to
Speaker 1: induce cardiac arrest. So we would see more and more
Speaker 1: experiments between eighteen twenty eight and nineteen thirty which is
Speaker 1: the next day I have on my my list, and
Speaker 1: I 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 that's when a fellow by
Speaker 1: the 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. 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 in to a person
Speaker 1: and by turning the hand crank. There was also a
Speaker 1: spring motor inside of it that turned a magneto, which
Speaker 1: is a DC 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 crank, it's turning it through this magnetic field,
Speaker 1: and that's inducing electricity to throw to flow rather and
Speaker 1: that ends up supplying the electricity needed for the pacemaker.
Speaker 1: The insulation needle would deliver the electric charge to the
Speaker 1: right atrium of the heart, and by March first, nineteen
Speaker 1: thirty two, the pacemaker had been used forty three times
Speaker 1: with a successful outcome in fourteen cases, which is about
Speaker 1: a thirty three pc success rate, which sounds incredibly low,
Speaker 1: but then keep in mind that the essentially this was
Speaker 1: an absolute last Yeah, this was the last last ditch
Speaker 1: effort to try and revive someone. So it wasn't like
Speaker 1: this what These were not the type of pacemakers we've
Speaker 1: talked about in our episode where we talked about the
Speaker 1: things that you would have in your in your chest
Speaker 1: for a prolonged period. This was really meant to revive someone. Yeah,
Speaker 1: so this is this is a little different thing. Patients
Speaker 1: saved is actually better than zero percent. So 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: Ninety nine an elderly man who in the literature is
Speaker 1: called 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 spontaneous cardiac activity. It had essentially had the ability
Speaker 1: to tell if something was going wrong. It wasn't necessarily
Speaker 1: able to respond to that dynamically, but it could at
Speaker 1: least warn a caregiver just something something was happening. Um,
Speaker 1: everything was it was, yeah, it worked all right. The
Speaker 1: one problem was that the area where the electrodes would
Speaker 1: go in through the skin, essentially the needle would go
Speaker 1: in through the skin um was prone to minor infections.
Speaker 1: There was never like that's what you would expect from
Speaker 1: from I mean, and that's part of the reason why
Speaker 1: the drive to create implantable racemakers exist. And we talked about,
Speaker 1: you know the fact that in our piercing episode or
Speaker 1: our body modification episode, we talked about that there is
Speaker 1: a a possibility of developing these kind of infections and
Speaker 1: they may not be serious, it may not be life threatening,
Speaker 1: but they can be problematic. And that was exactly what
Speaker 1: he had experienced. It wasn't an infection that was developing
Speaker 1: into sepsis, but it was like he would have to
Speaker 1: have the area cleaned regularly so that he could clear
Speaker 1: out any infection. UH. In late nineteen sixty two, he
Speaker 1: underwent surgery for a pacemaker implant, but he never fully recovered.
Speaker 1: In fact, he never recovered from the surgical procedure. He
Speaker 1: died twenty days after the surgical procedure, So that was
Speaker 1: an unfortunate tragedy there, but he did have lived for
Speaker 1: several years with this external pacemaker. In nineteen sixty, doctor
Speaker 1: Robert Rubio implanted a pacemaker into a female patient, and
Speaker 1: that pacemaker was fifty two point five millimeters in diameter,
Speaker 1: which is about two inches seventeen point five millimeters thick,
Speaker 1: which is about points seven inches, so just over half
Speaker 1: an inch, and wade sixty four point three grams or
Speaker 1: two point three ounces or less than a quarter of
Speaker 1: a pound. Now that one got power from two rechargeable
Speaker 1: nickel cadmium batteries which were charged through induction from an
Speaker 1: external flexible coil placed on the skin over the pacemaker.
Speaker 1: So this is the way some pacemakers are recharged today
Speaker 1: using a similar approach, although it's usually radio frequencies. But
Speaker 1: what we're talking about wireless power here right where you
Speaker 1: can induce this charging through um again, your your create.
Speaker 1: It's all about magnetic fields and electricity is really what
Speaker 1: we get down to. So you would have to place
Speaker 1: this flexible coil directly over your heart in order to
Speaker 1: recharge the pacemaker, or really directly over the pacemaker wherever
Speaker 1: the pacemaker was located, wherever the you know, the battery was.
Speaker 1: The stimulated electrode for this was a platinum disk so
Speaker 1: it was an expensive piece of medical technology. But sadly,
Speaker 1: the patient died nine and a half months after the
Speaker 1: surgery because she did develop an infection which turned into
Speaker 1: sepsis after the surgery. So the pacemaker was working, but
Speaker 1: the it was a side effect of the surgery. She
Speaker 1: unfortunately perished from that. So really implanable pacemakers varied widely
Speaker 1: and how long they could operate before requiring a recharge.
Speaker 1: So one of them would only go like eight hours
Speaker 1: and then you have to recharge it. That's pretty yeah,
Speaker 1: that's pretty yeah. But there were others that could go
Speaker 1: weeks or even months before a recharge, even in the
Speaker 1: early days in the sixties. Uh. This this also, I
Speaker 1: mean still today, how much how much your your pacemaker
Speaker 1: is actually needing to to create a charge will make
Speaker 1: your battery life very right. So in other words, in
Speaker 1: other words, if if it's only occasionally having to intervene,
Speaker 1: then you're recharging, you may not need to recharge it
Speaker 1: as frequently as someone where it's more active more frequently.
Speaker 1: Um So, in the nineteen sixties, that's when we started
Speaker 1: to see the cardiac stimulator defibrillators, which we kind of
Speaker 1: talked about it's under a called something else today, but
Speaker 1: same sort of idea that the device that can UH
Speaker 1: detect when a heart beat stops and then try to
Speaker 1: restart it with a trolled electrical burst to the heart. Uh.
Speaker 1: The early versions of that we're also not implantable. They
Speaker 1: were external as well, but now we've got implantable ones
Speaker 1: that are incorporated with sort of pacemaker technology. UM. Now,
Speaker 1: as far as the future goes, because from the nineteen
Speaker 1: sixties on to the present, it was really refining that process.
Speaker 1: It's just miniaturization and improvements in electrical stimulation ye yep,
Speaker 1: making sure that we were getting more precise and smaller.
Speaker 1: Those are really the trends. So anything from nineteen sixties
Speaker 1: on is more about refining that that design. Uh. Talking
Speaker 1: about the future, miniaturization is going to continue to be
Speaker 1: a factor. In fact, there are companies right now that
Speaker 1: are trying to create pacemakers. They are about the size
Speaker 1: of a pill, so that tiny. So the reason why
Speaker 1: you want this is not just because it it takes
Speaker 1: up less space in the patient. Really, it's because the
Speaker 1: surgical procedures become less invasive, it's less damaged to the body,
Speaker 1: less chance for infection, Uh, makes it less chance for
Speaker 1: some thing to go wrong because you're it's just it's
Speaker 1: just a smaller surgical procedure. So that's really where we're
Speaker 1: seeing the future come in as far as pacemakers are concerned.
Speaker 1: And that wraps up this classic episode of tech Stuff.
Speaker 1: Hope you guys enjoyed it. If you have any suggestions
Speaker 1: for future topics that we should cover on the show,
Speaker 1: reach out on Twitter or Facebook. The handle it both
Speaker 1: of those is text Stuff h s W and I'll
Speaker 1: talk to you again really soon. Y. Text Stuff is
Speaker 1: an I Heart Radio production. For more podcasts from my
Speaker 1: Heart Radio, visit the i Heart Radio app, Apple Podcasts,
Speaker 1: or wherever you listen to your favorite shows.