Editing Pacemaker (section)

=== Implantable ===
[[File:PPM.png|thumb|350px|Illustration of implanted cardiac pacemaker showing locations of cardiac pacemaker leads]]
The first clinical implantation into a human of a fully implantable pacemaker was on October 8, 1958,<ref>{{cite book |last1=Tesler |first1=Ugo Filippo |title=A History of Cardiac Surgery: An Adventurous Voyage from Antiquity to the Artificial Heart |date=2020 |publisher=Cambridge Scholars Publishing |isbn=978-1-5275-4480-2 |page=151 }}</ref> at the [[Karolinska Institute]] in Solna, [[Sweden]], using a pacemaker designed by inventor [[Rune Elmqvist]] and surgeon [[Åke Senning]] (in collaboration with Elema-Schönander AB, later Siemens-Elema AB), connected to electrodes attached to the [[myocardium]] of the heart by [[thoracotomy]]. The device failed after three hours. A second device was then implanted which lasted for two days. The world's first implantable pacemaker patient, [[Arne Larsson (patient)|Arne Larsson]], went on to receive 26 different pacemakers during his lifetime. He died in 2001, at the age of 86, outliving the inventor and the surgeon.<ref>{{cite news|last=Altman| first=Lawrence| title=Arne H. W. Larsson, 86; Had First Internal Pacemaker| url=https://www.nytimes.com/2002/01/18/world/arne-h-w-larsson-86-had-first-internal-pacemaker.html|access-date=3 March 2014|newspaper=New York Times|date=18 Jan 2002}}</ref>

In 1959, temporary [[transvenous pacing]] was first demonstrated by Seymour Furman and John Schwedel, whereby the [[catheter]] electrode was inserted via the patient's [[basilic vein]].<ref>{{cite journal |vauthors=Furman S, Schwedel JB | title = An intracardiac pacemaker for Stokes-Adams seizures | journal = N. Engl. J. Med. | volume = 261 | issue = 5 | pages = 943–48 | year = 1959 | pmid = 13825713 | doi=10.1056/NEJM195911052611904}}</ref>

In February 1960, an improved version of the Swedish Elmqvist design was implanted by Doctors [[Orestes Fiandra]] and Roberto Rubio in the Casmu 1 Hospital of [[Montevideo]], Uruguay. This pacemaker, the first implanted in the Americas, lasted until the patient died of other ailments, nine months later. The early Swedish-designed devices used batteries recharged by an induction coil from the outside.

Implantable pacemakers constructed by engineer [[Wilson Greatbatch]] entered use in humans from April 1960 following extensive [[animal testing]]. The Greatbatch innovation varied from the earlier Swedish devices in using primary cells (a [[mercury battery]]) as the energy source. The first patient lived for a further 18 months.

The first use of [[transvenous pacing]] in conjunction with an implanted pacemaker was by [[Victor Parsonnet|Parsonnet]] in the United States,<ref name="pmid83641">{{cite journal | vauthors = Parsonnet V | title = Permanent transvenous pacing in 1962 | journal = Pacing Clin Electrophysiol | volume = 1 | issue = 2 | pages = 265–68 | year = 1978 | pmid = 83641 | doi = 10.1111/j.1540-8159.1978.tb03472.x| s2cid = 12263609 }}</ref><ref>{{cite journal | title = Preliminary Investigation of the Development of a Permanent Implantable Pacemaker Using an Intracardiac Dipolar Electrode |vauthors=Parsonnet V, Zucker IR, Asa MM | journal = Clin. Res. | volume = 10  | pages = 391 | year = 1962}}</ref><ref name="pmid14484083">{{cite journal | vauthors = Parsonnet V, Zucker IR, Gilbert L, Asa M | title = An intracardiac bipolar electrode for interim treatment of complete heart block | journal = Am. J. Cardiol. | volume = 10 | issue = 2| pages = 261–65 | year = 1962 | pmid = 14484083 | doi =10.1016/0002-9149(62)90305-3 }}</ref> Lagergren in Sweden<ref>{{cite journal | author = Lagergren H | title = How it happened: my recollection of early pacing | journal = Pacing Clin Electrophysiol | volume = 1 | issue = 1 | pages = 140–43 | year = 1978 | pmid = 83610 | doi = 10.1111/j.1540-8159.1978.tb03451.x | s2cid = 9118036 }}</ref><ref>{{cite journal |vauthors=Lagergren H, Johansson L | title = Intracardiac stimulation for complete heart block | journal = Acta Chirurgica Scandinavica | volume = 125 | pages = 562–66 | year = 1963 | pmid = 13928055 }}</ref> and Jean-Jacques Welti in France<ref>Jean Jacques Welti:Biography, Heart Rhythm Foundation{{Full citation needed|date=October 2020}}</ref> in 1962–63.
The transvenous, or pervenous, procedure involved incision of a vein into which was inserted the [[catheter]] electrode lead under [[Fluoroscopy|fluoroscopic]] guidance, until it was lodged within the [[trabeculae]] of the right ventricle. This became the method of choice by the mid-1960s.

Cardiothoracic surgeon [[Leon Abrams]] and medical engineer [[Ray Lightwood]] developed and implanted the first patient-controlled variable-rate heart pacemaker in 1960 at [[the University of Birmingham]]. The first implant took place in March 1960, with two further implants the following month. These three patients made good recoveries and returned to a high quality of life. By 1966, 56 patients had undergone implantation with one surviving for over {{frac|5|1|2}} years.<ref>[http://www.birmingham.ac.uk/documents/culture/bookletfinalpdf.pdf Blue Plaque Guide]</ref><ref>{{cite web|url=http://bhamalumni.org/NetCommunity/Page.aspx?pid=1111&frcrld=1|archive-url=https://web.archive.org/web/20141006065509/http://bhamalumni.org/NetCommunity/Page.aspx?pid=1111&frcrld=1|url-status=dead|archive-date=2014-10-06|title=University of Birmingham|work=bhamalumni.org}}</ref>