Machines in Our Hearts: The Cardiac Pacemaker, the Implantable Defibrillator, and American Health Care

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JHU Press, May 7, 2001 - History - 370 pages
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Today hundreds of thousands of Americans carry pacemakers and implantable cardioverter-defibrillators (ICDs) within their bodies. These battery-powered machinesósmall computers, in factódeliver electricity to the heart to correct dangerous disorders of the heartbeat. But few doctors, patients, or scholars know the history of these devices or how "heart-rhythm management" evolved into a multi-billion-dollar manufacturing and service industry.

Machines in Our Hearts tells the story of these two implantable medical devices. Kirk Jeffrey, a historian of science and technology, traces the development of knowledge about the human heartbeat and follows surgeons, cardiologists, and engineers as they invent and test a variety of electronic devices. Numerous small manufacturing firms jumped into pacemaker production but eventually fell by the wayside, leaving only three American companies in the business today. Jeffrey profiles pioneering heart surgeons, inventors from the realms of engineering and medical research, and business leaders who built heart-rhythm management into an industry with thousands of employees and annual revenues in the hundreds of millions. As Jeffrey shows, the pacemaker (first implanted in 1958) and the ICD (1980) embody a paradox of high-tech health care: these technologies are effective and reliable but add billions to the nation's medical bill because of the huge growth in the number of patients who depend on implanted devices to manage their heartbeats.

  

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Contents

INTRODUCTION
1
HEART BLOCK AND THE HEART TICKLER
14
THE WAR ON HEART DISEASE AND THE INVENTION OF CARDIAC PACING
36
HEART SURGEONS REDEFINE CARDIAC PACING
58
THE MULTIPLE INVENTION OF IMPLANTABLE PACEMAKERS
83
MAKING THE PACEMAKER SAFE AND RELIABLE
107
THE INDUSTRIALIZATION OF THE PACEMAKER
136
THE PACEMAKER BECOMES A FLEXIBLE MACHINE
161
PREVENTING SUDDEN CARDIAC DEATH THE IMPLANTABLE DEFIBRILLATOR
235
THE 1990S AND BEYOND WHEN LIFE DEPENDS ON MEDICAL TECHNOLOGY
263
DEVICE RELIABILITY QUALIFICATION TESTS AND IMPROVEMENTS
291
NUMBER OF IMPLANTATIONS
294
ICHD PACEMAKER IDENTIFICATION CODE
296
ABBREVIATIONS
297
NOTES
299
BIBLIOGRAPHICAL NOTE
353

SLOWING THE PACE THE INDUSTRYS TIME OF TROUBLES
186
COMPETITION THROUGH INNOVATION ACCELERATING THE PACE OF CHANGE
209

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References to this book

The Heart
James Peto
Limited preview - 2007

About the author (2001)

Kirk Jeffrey is a professor of history at Carleton College, where he teaches American history and the history of technology. He is coauthor (with mathematician Loren Haskins) of Understanding Quantitative History.

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