Cover image for Machines in our hearts : the cardiac pacemaker, the implantable defibrillator, and American health care
Machines in our hearts : the cardiac pacemaker, the implantable defibrillator, and American health care
Jeffrey, Kirk.
Personal Author:
Publication Information:
Baltimore : Johns Hopkins University Press, [2001]

Physical Description:
xiii, 370 pages : illustrations ; 24 cm
Format :


Call Number
Material Type
Home Location
Item Holds
RC684.P3 J444 2001 Adult Non-Fiction Non-Fiction Area

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Today hundreds of thousands of Americans carry pacemakers and implantable cardioverter-defibrillators (ICDs) within their bodies. These battery-powered machines--small computers, in fact--deliver 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.

Author Notes

Kirk Jeffrey is a professor of history at Carleton College.

Reviews 1

Choice Review

The history of machines that provide electricity to the heart to alter lethal heartbeat rhythms is little known or understood by the general public or the medical profession. Jeffrey (history, Carleton College) traces the history of the development and use of two of these devices, the cardiac pacemaker and the implantable defibrillator, and their impact on US health care. The story of how a number of small manufacturing companies first produced these battery-powered machines (computers) but gave way to only three companies making these devices today is a fascinating but sobering look at the realities of competition in the medical products industry. The cardiac pacemaker was first implanted in 1958 and the implantable defibrillator in 1980. These devices have improved the quality of life and saved the lives of countless numbers of patients. Although their reliability and effectiveness are well known, their use has greatly increased costs in the US health care system. These issues are effectively and interestingly presented. Useful appendix and notes. For medical professionals and graduate students interested in the history, social sciences, and economics of health care, as well as others with focused interests. R. L. Jones emeritus, Pennsylvania State University, Hershey Medical Center

Table of Contents

1 Heart Block and the Heart Tickler
2 The War on Heart Disease and the Invention of Cardiac Pacing
3 Heart Surgeons Redefine Cardiac Pacing
4 The Multiple Invention of Implantable Pacemakers
5 Making the Pacemaker Safe and Reliable
6 The Industrialization of the Pacemaker
7 The Pacemaker Becomes a Flexible Machine
8 Slowing the Pace: The Industry's Time of Troubles
9 Competition through Innovation: Accelerating the Pace of Change
10 Preventing Sudden Cardiac Death: The Implantable Defibrillator