Monday, February 20, 2012

John A. Hopps: The Cardiac Pacemaker

Great Advances in Science

John Hopps is seen testing the world’s first pacemaker in this 1946 photo.
Photo Credit: National Research Council of Canada
Source: CBC News

It has been more than 60 years since the first cardiac pacemaker was developed by John A. Hopps, a Canadian electrical engineer long considered the Father of Bioengineering. Known as “Jack” to his colleagues, Hopps’ invention and the refinement of it has saved millions of lives.

Today, the pacemaker is the size of a 50-cent coin, and the medical procedure is usually performed under local anesthetic, lasting about an hour. An artificial pacemaker typically lasts 10 years. Like most discoveries, the invention of the cardiac pacemaker came in stages, each one a marked improvement of previous accomplishments. The first external pacemaker was developed in 1950, and the first pacemaker implanted in a human was in 1958, by Dr. Ake Senning, a Swedish surgeon.
The first recipient of an implantable pacemaker was Arne Larsson in 1958. The prototype was about the size of a tin of shoe polish. It was built in the kitchen of Dr. Rune Elmqvist, and implanted by Dr. Åke Senning, a cardiac surgeon at Karolinska University Hospital in Solna, Sweden.
But it has to start with one individual, the pioneer. John Alexander Hopps was born in Winnipeg, Manitoba, on May 21, 1919. He graduated  with a degree in electrical engineering from University of Manitoba in 1941, and soon after joined the National Research Council. It was there that Hopps developed the pacemaker along with Dr. William Bigelow and Dr. John Callaghan at University of Toronto’s Banting and Best Institute laboratory in Toronto. They were doing research on hypothermia, where the body's temperature drops below what is necessary for regular metabolism and function. (There is a 1984 CBC interview with John Hopps here and some background information here.).

Modern Cardiac Pacemaker: This is a pacemaker generator, which is bout the size of a 50-cent coin, and three times as thick. Typically, the heart rate is between 60 and 100 beats per minute. It can drop to 40 at rest and rise to 200 when excited, such as when exercising. Pacemakers are electronic devices that are implanted under the skin, helping to regulate a heartbeat that has slowed down. The generator is connected via two leads insulated (wires) that are inserted through a vein into the heart, typically into the right atrium and the right ventricle. Pacemakers send small currents to stimulate and regulate the heart.
Photo Credit: J. Heuser, 2005
Source: Wikipedia

Hopps himself became one of the beneficiaries of his invention, having a pacemaker implanted in 1984. In an article about the invention of the pacemaker in Canadian Archivers, Hopps says credit ought to be shared:
"There's always been a bone of contention surrounding the 'invention' of the pacemaker," Dr. Hopps says. "In truth, no single one invented it. However, ours was the first of its kind. In 1950, we at NRC were collaborating in a hypothermia study by Dr. W.G. Bigelow at the University of Toronto. Dr. Bigelow observed that a cold heart could be triggered into activity by a mechanical or electrical stimulus. We developed a device to maintain or activate the heart beat as an adjunct to that investigation.

"We called our device a pacemaker after nature's own pacemaker, the sinoatrial node which normally organizes the heart's rate. It appeared to be a good descriptive name for the device. Subsequently, other devices designed to control the heart beat were called pacemakers.

"Those were good times for research in Canada. I doubt very much if the pacemaker would be developed today, that's how much times have changed. Things then were much more flexible. Now our science is so circumscribed with the desire to assist industry that there is little pure research being done in the country today, particularly by the government.
I doubt that the situation for scientific funding has improved since then, the 1980s. We now live in more pragmatic times and the non-scientific consider pure research a "waste of money." There is little patience and instant results are expected. Except for the fact that without it, research that is, we will not advance as a society. That's hard for the "bean counters" to understand.

John A Hopps died on November 24, 1998. He was 79. His wife, Eleanor, died before him, and he left behind a daughter, Margaret, two sons, Donald and John, six grandchildren, and a great grandson. That's a wonderful legacy, adding to his scientific one. It's exciting when an invention leads to bettering the life of humans. This is one of them.

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