Wilson Greatbatch (1919–2011)

S. Serge Barold

Florida Heart Rhythm Institute, Tampa, Florida, USA

Wilson Greatbatch was born September 6, 1919, in Buffalo, New York State as the only child of Warren Greatbatch a construction contractor and Charlotte Greatbatch who worked as a secretary. He died on September 27, 2011 at the age of 92. Greatbatch trained as an electrical engineer at Cor- nell University and the University of Buffalo where he then taught engineering between 1952 and 1957. While building an oscillator to record heart sounds, Greatbatch made a fortuitous discovery. He grabbed the wrong resistor from a box and plugged it into the circuit he was making. The unit gave off a startling- ly familiar, uneven electrical pulse. The circuit pulsed for 1.8 ms, stopped for 1 s and the sequence was then Figure 1. The “bow tie” trio. Left, William Chardack, repeated. This serendipitous moment changed his- Andrew Gage, and Wilson Greatbatch at the bedside of tory. Greatbatch described the incident in his 2000 one of the first recipients of their pacemaker. memoir “The Making of the Pacemaker” by saying “I stared at the thing in disbelief and then realized that this was exactly what was needed to drive medical device company in the world. The first suc- a heart.” This was an example of Pasteur’s observa- cessful implantation of the Greatbatch pacemaker tion that “chance favors the prepared mind.” took place in April 1960 by Chardack at the Buffalo On May 7, 1958, Greatbatch brought what Veterans’ Affairs Hospital, after extensive animal would become the world’s first implantable cardiac testing (Fig. 1) [2, 3]. The 77-year-old patient lived pacemaker, made with two Texas Instrument tran- for 18 months after the device was implanted. Ano- sistors, to William M. Chardack who was chief of ther member of the initial group lived for 30 years. surgery at the Buffalo Veterans’ Hospital. There, Compared to the original Swedish pacemaker, Great- Chardack and another surgeon, Andrew Gage, ex- batch’s pacemaker was a huge leap forward because posed the heart of a dog on which two pacemaker it incorporated smaller nonrechargeable mercury- wires were applied. The pacemaker took control of zinc batteries making the device truly implantable. the heartbeat to the utter amazement of the inves- During 1960 Chardack and his associates implanted tigators. The device which was wrapped in electric pacemakers in 10 patients, most over 60 years of age. tape lasted 4 hours. On this experience, Greatbatch Two were children. All ten had complete heart block, scribbled in his lab diary “I seriously doubt if any- so that without pacemakers they had perhaps thing I ever do will ever give me the elation I felt a 50-percent chance of living more than a year. Forty that day when my own two cubic inch piece of elec- of Greatbatch’s units would go into animals. Great- tronic design controlled a living heart.” [1]. batch had opened the door for pacemaker industry. Greatbatch retreated to his backyard work- Transvenous implantation had to wait until 1962. shop, a barn heated by a wood-burning stove. There, Greatbatch was not the first to come up with he made 50 pacemakers by hand. These devices a surgically implanted pacemaker. That happened were built with proper casing. This work would in 1958 in Sweden, using a device designed by Rune eventually launch Medtronic presently the biggest Elmqvist. Ake Senning attempted the first human

Address for correspondence: S. Serge Barold, MD, Florida Heart Rhythm Institute, Tampa, Florida, USA, tel: 813 891 1922, e-mail: [email protected] Received: 03.10.2011 Accepted: 03.10.2011

718 www.cardiologyjournal.org S. Serge Barold, Wilson Greatbatch (1919–2011) pacemaker implantation late in 1958. The unit failed Inventing was Greatbatch’s lifelong passion and after 3 hours. A second unit worked for 8 days be- several sources indicate he had over 300 patents fore failing. An improved version of the Elmqvist to his name. He was awarded ScD degrees from pacemaker was implanted in February 1960 in Mon- several universities. In 1983, the implantable pace- tevideo, Uruguay and that device functioned suc- maker was named one of the 10 greatest engineer- cessfully for 9 months until the patient died [4]. The ing contributions to society during the past 50 years Swedish pacemakers had rechargeable batteries. by the US National Society of Professional Engi- On this basis, Greatbatch can rightfully be conside- neers. In 1984, Greatbatch received the Distin- red the inventor of the first practical self-contained guished Scientist Award from the Heart Rhythm implantable pacemaker. Society (formely NASPE). For his contributions to Greatbatch filed for a U.S. patent on the car- science, Greatbatch received the National Technolo- diac pacemaker July 22, 1960. In 1961, he sold the gy Medal in 1990 from President George H.W. Bush. rights to produce and market his “implantable pulse In 1996 Greatbatch was awarded the Lemelson-MIT generator” to Minneapolis-based Medtronic Inc. My Prize for lifetime achievement. In 1998 he was ad- first exposure to pacing during my cardiology train- mitted to the National Inventors’ Hall of Fame in ing actually involved Medtronic pacemakers with Akron, Ohio following in the footsteps of his hero, a prominent “Chardack-Greatbatch Pulse Genera- inventor Thomas Edison. In 2001 he was granted tor” label on the device themselves. the highest honor from the National Academy of Soon the battery became the biggest problem. Engineering, shared with Earl Bakken, who invent- The Greatbatch pacemaker featured a mercury-zinc ed the external pacemaker and founded Medtronic. battery that lasted about two years. Greatbatch Greatbatch is half of the namesake for the presti- grew increasingly frustrated with battery techno- gious AAMI Foundation Laufman-Greatbatch Prize, logy and the limitations it imposed. The mercury- which is given annually to an individual or group zinc battery was cast in epoxy which was porous to who made unique and significant contributions the discharge of battery released hydrogen. This to the advancement of medical instrumentation allowed fluid leaks into the pacemaker at times and patient safety. causing electrical shorting and premature failure. Greatbatch described himself as a “humble Indeed, Greatbatch referred to these mercury-zinc tinkerer.” He was indeed a humble and wonderful pacemakers as “running under water” because human being. He was gentle and unassuming. He water vapor is a gas. In the early 70s, Greatbatch was very approachable and always available to the left the world of pacemakers and began manufac- medical community to answer technical questions. turing lithium batteries. He acquired rights to a lith- To many of his friends and admirers, he had a “heart ium-iodide design invented in 1968 by researchers of gold.” Words cannot adequately describe the in a small Baltimore company that could not find impact that Greatbatch had on the lives of count- a commercial application for their product. In 1970 less people. He was an outstanding personality of Greatbatch founded a company to manufacture bat- our time. A great man has left us. Wilson Greatbatch teries for the implantable pacemaker. He devised is survived by his daughter and his three sons. His a more durable lithium-iodide cell that became the wife Eleanor the maker of his trademark bow ties industry standard. By 1972 Greatbatch had re-en- died in January. One son predeceased him. gineered the battery into a compact sealed package that could be implanted in the body for a decade or Disclosures more. In this way, Greatbatch became the first to introduce the lithium-iodide battery into a pacemak- The author does not report any conflict of in- er a step that revolutionized cardiac pacing. The terest regarding this work. battery had no gas emission and could be hermeti- cally sealed thereby increasing device reliability. References The new battery had a life of 10 years compared to only 2 years of the old mercury-zinc battery; this 1. Greatbatch W. The making of the pacemaker: Celebrating a life- further greatly advanced the use and acceptance of -saving invention. Prometheus Books, Amherst, New York 2001. 2. Chardack WM, Gage AA, Greatbatch W. A transistorized, self- implantable pacemakers. The new batteries became -contained, implantable pacemaker For the long-term correction the workhorse and the gold standard for many med- of complete heart block. Surgery, 1960; 48: 643–664. ical devices in addition to pacemakers. The new 3. Chardack WM. Recollections — 1958–1961. Pacing Clin Elec- company became a major producer of pacemaker trophysiol, 1981; 4: 592–596. 4. Fiandra O. The first pacemaker in America. Pacing Clin Electro- batteries and continues to manufacture them to physiol, 1988; 11: 1234–1235. this day. http://www.ieeeghn.org/wiki/index.php/Oral-History: Wilson_Greatbatch