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Origin of the Internal Pacemaker
In the year 1952 Paul Zoll created an astonishing device known as the external pacemaker. Zoll’s creation was to help with irregular heartbeats by controlling their pulse rates. Unfortunately, this device was not like a hand-held pilot, it was fairly huge in size. This external pacemaker was about the size of a small television. It administered lifesaving jolts of electricity, which sometimes burned people’s skin.

Creation of the Internal Pacemaker
One day, a medical researcher named Wilson Greatbatch was working on a device to record irregular heartbeats. “I think it was a mystery of it that attracted me,” Greatbatch stated. In attempt to record the sound of a heartbeat, Greatbatch had created something far more crucial. He had created a device that emitted electricity pulses to the heart. It was this discovery that led to the implantable cardiac pacemaker. Greatbatch once said, “History has repeatedly shown that when a new method or material becomes available, new uses for it arise”.

While Greatbatch was first learning of the heart block, a condition in which a nerve fails to send electrical impulses to make the heart work, he had been talking with two surgeons visiting Cornell University in the early 1950’s. At the time combating the heart block was done with the painful external pacemaker. But in 1958 Greatbatch’s “eureka moment” happened. “I stared at the things in disbelief, thinking this was exactly the properties of a pacemaker,” he said. He had licensed his invention to Medtronic Inc. and the first pacemaker was implanted in a human in 1960.

In 1970 Greatbatch upgraded his device using a lithium battery for durability. Ever since his device was created, it has been saving his lives and in 1996 he was honored with the Lemelson-MIT Lifetime Achievement Award. To this day millions of internal pacemakers are being implanted and used by people of all ages. Greatbatch, in amazement stated, “I seriously doubt if anything I ever do will ever give me the elation I felt that day when my own two cubic inch piece of electronic design controlled a living heart”).

Usage
The internal pacemaker is used to help keep the heart beating in a regular rhythm. A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart. Then again, most pacemakers are demand pacemakers. They have sensing devices. This sensing device turns the signal off when the heartbeat is above a certain level. It also turns the signal back on when the heartbeat is too slow.

International Significance
The internal pacemaker is an international significant event. The implants are taken place all over the world by different doctors and surgeons. Wilson Greatbatch, who created the internal pacemaker, created this device outside of the United States. To be specific, this device was founded in Canada at a University. No one is rejected because of their ethnicity, but simply if you need one you get one. It is not a competition on which country can insert the most pacemakers, but the goal is to save as many lives as possible. And for death to be inevitable there is no start and no stop, so therefore as many lives as you can save is by far an international significant event.

Doctor's Perspective
Surgeons view internal pacemakers as a common fix for bradycardia and heartblocks. A heartblock is a problem with the heart’s electrical system. Before recommending a pacemaker, doctors will consider any arrhythmia symptoms you have, such as dizziness, unexplained fainting, or shortness of breath. He or she also will consider whether you have a history of heart disease, what medicines you're currently taking, and the results of heart tests. As lengthy as these procedures may often become, they have no problem in inserting them. “I don’t dawdle. I am a surgeon. I make an incision, do what needs to be done and sew up the wound. There is a beginning, middle and an end”. Before giving the surgery, they offer certain tips to follow once the surgery has been completed such as: don’t face the shower head directly on the incision until it is fully healed, count your pulse and be sure to notice if you have shortness of breath, and many more. Most surgeons don’t have thorough based opinions on the pacemaker itself, but the opinion comes with the patient’s outcome of the implantation.

Patient's Perspective
Looking from a patient’s perspective, there are both advantages and disadvantages in having an internal pacemaker. With different patients’ viewpoints comes the issue with whether or not they ever needed the implant in the first place. One patient said, “The pacemaker helps my heart, but I can’t really play any contact sports, which sucks”. Most pacemakers are implanted to help treat “bradycardia”, which is the slowing of the heartbeat. At rest, the heart usually beats about 50 to 70 times each minute, and the heart rate may increase 2- to 3-fold during stress or exercise. This patient was also interviewed for a public debate on whether or not the device benefits her. “The internal pacemaker is not only a machine inside me; it keeps my heart at a stable rate, allowing me to participate in some, though not all sports”. So, even though she isn’t able to play certain sports involving specific interaction; however, she is still able to participate in several activities.

On the other hand there are also patients who feel as though their implantations were not even necessary. According to a study done in Philadelphia County in 1983, three hundred and eighty two Medicare patients who received an internal pacemaker were either definitely indicated, possibly or not at all indicated. Medical records were reviewed in detail, and cardiologists with expertise in pacemakers developed the standards and reviewed the records. The results of this study were as follows: forty-four percent of the pacemakers were definitely indicated, thirty-six percent were possibly indicated, and twenty percent were not indicated. Surprisingly, this pattern was apparent in all types of hospitals, including teaching hospitals.