Engineers Australia highlights Ballarat innovator Geoffrey Wickham, who was a pioneer in developing the pacemaker.
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00:00 [Music]
00:07 Having graduated medicine in 1966,
00:10 I started implanting pacemakers in 1970 at the Royal Melbourne Hospital.
00:16 Pacemakers were first used in Australia.
00:19 In 1929, Mark C Lidwell implanted a needle into the heart of a stillborn baby
00:28 and as a result of this, he managed to get the heart working.
00:33 It was the first case and is acknowledged in the literature today.
00:38 In those early days at the Royal Melbourne Hospital in 1959,
00:43 Dr. Graham Simon really started cardiology.
00:46 Very few physicians around the world were performing cardiac pacing.
00:51 And it was even before I joined the department,
00:54 he convinced me to start the pacemaker clinic.
00:57 His influence was absolutely profound.
01:01 The treatment of sudden death with the heart no longer beating
01:07 was the thing that we were concentrating on for the first few years.
01:11 I and others had designed a technique where we made an incision under the collarbone
01:17 and found a vein and thread a wire into the heart
01:21 and in this way we could pace the heart.
01:24 Pacemakers were actually built by our electronic engineering department.
01:29 They would take a small amount of electronics and they would pot it in an epoxy resin
01:35 and presto, we had a pacemaker to implant.
01:39 It was a gradual process with pacemakers, initially external,
01:44 but eventually was put in internally.
01:49 At that stage, pacemakers were not really considered as a medical device.
01:55 I first became involved in pacemaking in 1964
02:00 as a consequence of being a partner in a small engineering company
02:04 manufacturing electronic devices
02:06 and I was introduced to the chief of cardiothoracic surgery
02:10 at Royal Prince Alfred Hospital in Sydney
02:12 who explained to me that he was having trouble with his new devices
02:17 which he called heart batteries.
02:19 That's how it all started.
02:21 Geoff Wickham of Telectronics is a legend in pacing
02:25 and had the idea of developing a pacemaker to stimulate the heart.
02:31 Initially the pacemaker was a fairly bulky object
02:34 and it was inevitable that evolution would lead to a smaller pacemaker.
02:39 The challenge was to find out how to do it.
02:41 This is one of our earliest pacemakers
02:45 and here is one of the currently produced mini models.
02:49 This miniaturisation will naturally make for much greater comfort.
02:54 Australia was in the forefront in those early years
02:57 and telechronics did play a very important part.
03:02 Then we became comfortable using a device that we knew was reliable.
03:09 You can take this home. This will check your pacemaker yourself.
03:12 Press the button. I'll put it on the back of your hand if that's a matter.
03:16 72.4. Yes, lovely.
03:18 The ideas that came out once they had developed the first pacemakers were remarkable.
03:25 The evolutionary milestones were first of all in 1969,
03:30 the change from discrete circuitry to a microcircuit.
03:35 The other big problem was the plastics.
03:39 Oxyresin is permeable to water vapour and that leads to corrosion and of course electronic failure.
03:45 We overcame that by developing a sealed welded titanium case.
03:50 We were the first in the world to do that.
03:52 At that same stage in 1971, a pacemaker battery was developed by one Wilson Greatbatch
03:58 called a lithium iodide cell and that produced a massive step forward in reliability.
04:04 It was very important in that instead of having a need to put a new pacemaker in every three to six months,
04:13 the pacemakers were lasting for up to ten years.
04:17 We now push the wire as far as the heart.
04:23 Now we place the pulse generator inside the little prepared pocket.
04:28 It just pops in like that and we are ready now to close up the wound.
04:33 Then after that, Telectronics developed minute ventilation technology
04:38 which allowed the pacing rate to increase according to an increasing exercise.
04:44 I look back very fondly on my association with patients and the lives that I improved in these people.
04:52 To follow them for over 20 years is a great inspiration for me.
04:57 Your pacemaker is a triumph of collaboration between modern medicine and electronic technology.
05:04 Establishing the cardiac clinic was a very important milestone for the development of pacemakers.
05:12 Australians have always been natural innovators.
05:15 We've challenged ourselves to meet objectives beyond what was being achieved overseas.
05:21 It was the engineers' ideas and their ability to put it into practice that really changed the face of cardiac pacing.
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