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Health Technologies Essay




 

Wilson Greatbatch
President
Greatbatch Enterprises, Inc.

One can trace the beginning of health care technologies to the first electrocardiograph—a string galvanometer for recording heart voltages—invented in 1903 by Willem Einthoven in the Netherlands. In the late 1920s the advent of vacuum tubes to amplify the electrocardiograph allowed patients to get their hands and feet out of the saline buckets that were necessary to get a good contact with the ECG machine.

Some 20 years later, from 1949 to 1951, I was employed by the Cornell Psychology Department at its animal behavior farm in Varna, New York. My job involved instrumenting 100 sheep and goats for heart function, blood pressure, EEG, and body motion. All this, of course, was still being done with vacuum tube equipment.

Then came the invention of the transistor by Bell Laboratories. Once the transistor was readily available, I knew I could make an implantable pacemaker. Like most breakthrough developments, the implantable pacemaker was the result of a series of efforts, starting with Albert Hyman, who built a hand-crank pacemaker in the 1930s. In the early 1950s Paul M. Zoll built an external pacemaker that plugged into a wall socket, and Earl Bakken built a wearable pacemaker in 1958. That same year Åke Senning in Stockholm implanted the first pacemaker in a human, but the device was not successful. (We define "success" as an implanted device that performs satisfactorily for at least one year.)

By 1958 I had blocked out a transistorized pacemaker circuit and began looking for a surgeon interested in working with me. I met my surgeon partners, William Chardack, chief of surgery, and Andrew Gage at the Buffalo Veterans Administration Hospital. I had $2,000 in cash and enough to feed my family for 2 years, so I quit my job and gave the family money to my wife. Between 1958 and 1960, I built 50 pacemakers in the barn behind my house. We put 40 of them into animals and 10 into patients. In 1960 Chardack, Gage, and I achieved the first successful implanted cardiac pacemaker.

One of my current projects involves eliminating the dangerous interactions between magnetic resonance imaging (MRI) and implantable pacemakers and defibrillators. The powerful electromagnetic fields generated by the MRI machine can travel down the wire leads, possibly damaging the pacemaker circuitry and perhaps scarring the heart. We have worked with a client (Biophan, Inc.) to design, build, and test a pacemaker that eliminates the wire lead. An electronic pulse generator drives a laser, which conducts a light pulse to the heart, where the light pulse is converted back into an electrical impulse to drive the heart. Work is also under way to replace the lithium/silver vanadium battery in the implantable cardiac defibrillator with a hybrid battery that will provide long service life and decrease the charge time on capacitors.

I see the future of bioengineering as largely driven by developments in microtechnology, nanotechnology, and light technology. Researchers are already building motors visible only through a microscope. We are investigating chemical and electrical sensors that operate entirely on the photonic level, with no electronic instrumentation other than that needed to drive a laser. These low-power requirements raise the possibility of building and operating equipment on power generated by the human body itself.

Health care technology and bioengineering are interdisciplinary subjects. They require ideas, people, and intelligence from all the physical sciences, all the natural sciences, all the medical sciences, and all the photonic sciences. This varied group of people, converging under the subject of bioengineering, will shape the future, leading us to the greatest engineering achievements of the 21st century.


 


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