As the body’s primary device for pumping blood over the body, the heart was seen as the most critical organ (after the brain), protected by the rib cage. But even healthy bodies were vulnerable to diseases and defects. Aptly Dutch doctor-physiologist Willem Einthoven won the 1924 Nobel Prize in Medicine for electrocardiography.
![]()
His invention, cardiac pacemaker, has saved many lives and was named by National Geographic as being a Top Australian Invention That Changed the World. In order to avoid public controversy, Dr Lidwell unfortunately did NOT patent his invention, and he did NOT leave photos of the machine. But he did write a detailed report to 3rd Congress of the Australian Medical Society.
Having heard of Dr Lidwell’s success, Dr Albert Hyman (1893-1972) wanted to develop a similar device in NY. Hyman learned how to revive a stopped heart with intra-cardiac therapy. His plan was to inject drugs like epinephrine that caused the heart to move again, but realised that it was the physical act of inserting the needle that caused cardiac wall action. In 1932, this cardiologist resuscitated some patients using periodic voltage impulses. He built an electro-mechanical device and then pacemaker-powered by a hand-cranked motor.
Hyman's processes did not win general acceptance from U.S’s medical community that wasn’t ready to embrace cardiac electro-stimulation. Their opposition later caused him to turn to the US Navy in WW2, to use his device on military personnel dying in tents. Fortunately his vision evolved, with further expert work in Sweden etc.
In the 1950s scientists met the challenge of correcting the irregular beats caused by the heart’s natural pacemaker, the sinus node. And the advent of modern advancements led scientists and the medical society to improve the quality of pacemakers! The invention of silicon transistors and smaller batteries helped with portability.
In 1951, Canadian electrical engineer John Hopps of the National Research Council of Canada/NRC created the first external portable pacemaker that needed to be plugged into power points. Then Toronto Uni’s Wilfred Bigelow and John Callaghan, together with John Hopps, jointly published their work on heart stimulation.
In 1952 Boston cardiologist Dr Paul Zoll made the first practical external pacemaker. He used the basic circuitry from Canada’s NRC machine, but instead of having the electrodes attached to the heart itself, the electrodes were attached to the patient’s chest. This device wasn’t suitable for long-term use because 1] it could only be used while the patient was in hospital and 2] electric shocks to the chest skin involved pain. But the pacemaker got better with micro-technology, crediting Zoll as one of the forefathers of modern clinical cardiac pacing.
In 1957 scientist Earl Bakken, in response to American heart surgeon Dr Walton Lillehei, developed the first wearable transistorised pacemaker. This prototype was meant for laboratory use, but Lillehei liked it so much he used it on various patients. In 1958, prompted by Swedish Dr Åke Sennings, Dr Rune Elmqvist designed the first rechargeable, implantable pacemaker. Dr Senning implanted myocardial electrodes and a pulse generator with a rechargeable nickel-cadmium battery. The first fully implanted pacemaker was successfully installed in 1958. But it was not until later that long-life lithium batteries developed by Wilson Greatbach maximised pacemakers’ longevity.
![]()
![]()
![]()
British-born Mark Lidwill (1878-1968) emigrated with his parents to Australia in 1894. Lidwill studied medicine at Melbourne Uni, graduating with honours (1902) and a Doctorate in Medicine (1905). He invented unique medical tools & methods, including successfully designing & manufacturing the Lidwill Intra-Tracheal Anaesthetic Machine (1910), used in Australian operating theatres for 3 decades.
Crown St Women's Hospital, Sydney
now closed
He moved to Sydney in 1913, becoming an anaesthetics lecturer at Royal Prince Alfred Hospital. In 1926 he worked in anaesthetics & cardiology with Sydney Uni physicist Edgar Booth at Crown St Women's Hospital, inventing a portable machine for mechanical or insufflation anaesthesia. Dr Lidwill successfully revived a stillborn baby using electrical stimulation to the heart i.e he placed a needle directly into the baby’s heart, administering 16-volt impulses.
He moved to Sydney in 1913, becoming an anaesthetics lecturer at Royal Prince Alfred Hospital. In 1926 he worked in anaesthetics & cardiology with Sydney Uni physicist Edgar Booth at Crown St Women's Hospital, inventing a portable machine for mechanical or insufflation anaesthesia. Dr Lidwill successfully revived a stillborn baby using electrical stimulation to the heart i.e he placed a needle directly into the baby’s heart, administering 16-volt impulses.
His invention, cardiac pacemaker, has saved many lives and was named by National Geographic as being a Top Australian Invention That Changed the World. In order to avoid public controversy, Dr Lidwell unfortunately did NOT patent his invention, and he did NOT leave photos of the machine. But he did write a detailed report to 3rd Congress of the Australian Medical Society.
Having heard of Dr Lidwell’s success, Dr Albert Hyman (1893-1972) wanted to develop a similar device in NY. Hyman learned how to revive a stopped heart with intra-cardiac therapy. His plan was to inject drugs like epinephrine that caused the heart to move again, but realised that it was the physical act of inserting the needle that caused cardiac wall action. In 1932, this cardiologist resuscitated some patients using periodic voltage impulses. He built an electro-mechanical device and then pacemaker-powered by a hand-cranked motor.
Hyman's processes did not win general acceptance from U.S’s medical community that wasn’t ready to embrace cardiac electro-stimulation. Their opposition later caused him to turn to the US Navy in WW2, to use his device on military personnel dying in tents. Fortunately his vision evolved, with further expert work in Sweden etc.
In the 1950s scientists met the challenge of correcting the irregular beats caused by the heart’s natural pacemaker, the sinus node. And the advent of modern advancements led scientists and the medical society to improve the quality of pacemakers! The invention of silicon transistors and smaller batteries helped with portability.
In 1951, Canadian electrical engineer John Hopps of the National Research Council of Canada/NRC created the first external portable pacemaker that needed to be plugged into power points. Then Toronto Uni’s Wilfred Bigelow and John Callaghan, together with John Hopps, jointly published their work on heart stimulation.
In 1952 Boston cardiologist Dr Paul Zoll made the first practical external pacemaker. He used the basic circuitry from Canada’s NRC machine, but instead of having the electrodes attached to the heart itself, the electrodes were attached to the patient’s chest. This device wasn’t suitable for long-term use because 1] it could only be used while the patient was in hospital and 2] electric shocks to the chest skin involved pain. But the pacemaker got better with micro-technology, crediting Zoll as one of the forefathers of modern clinical cardiac pacing.
In 1957 scientist Earl Bakken, in response to American heart surgeon Dr Walton Lillehei, developed the first wearable transistorised pacemaker. This prototype was meant for laboratory use, but Lillehei liked it so much he used it on various patients. In 1958, prompted by Swedish Dr Åke Sennings, Dr Rune Elmqvist designed the first rechargeable, implantable pacemaker. Dr Senning implanted myocardial electrodes and a pulse generator with a rechargeable nickel-cadmium battery. The first fully implanted pacemaker was successfully installed in 1958. But it was not until later that long-life lithium batteries developed by Wilson Greatbach maximised pacemakers’ longevity.
Dr Lillehei examined a young patient wearing an external pacemaker
of the type invented by Earl Bakken, 1961.
Saturday Evening Post
of the type invented by Earl Bakken, 1961.
Saturday Evening Post
Trans-venous catheter pacing was introduced by Dr Seymour Furman in Montefiore Medical Centre in the Bronx in 1958. Here the electrode was passed down a vein to the interior of the heart, permitting the development of intracardiac diagnosis of arrythmias/abnormal heart rhythms. But fully implantable pace makers were impossible until the silicon transistor was developed. In 3 years of that first implant, a pulse generator attached to epicardial leads was implanted at Royal Melbourne Hospital. An engineer, with intermittent complete heart block, received epicardial leads and an external pulse generator. He proposed a simple sensing circuit, designing the first demand pacing system.
By the mid 1960s, physicians were inserting trans-venous leads in the right ventricle attached to pulse generators implanted in the anterior abdominal wall. An Australian pacemaker company founded in Sydney, Telectronics, designed many of the features of trans-venous leads and pulse generators we now have.
By the mid 1960s, physicians were inserting trans-venous leads in the right ventricle attached to pulse generators implanted in the anterior abdominal wall. An Australian pacemaker company founded in Sydney, Telectronics, designed many of the features of trans-venous leads and pulse generators we now have.
pacemaker before insertion, 2014
Universities Australia
Posteroanterior chest radiograph of a pacemaker
with normally located leads in the right atrium.
By 1969 the lithium battery-powered device sensed heart rhythms and generated beats accordingly, so it was classified as a demand-pacemaker. But there was a technological challenge; this pacemaker could not activate the heart’s upper chambers. Science responded with developments that allowed pacemakers to restore function to the heart’s lower chambers.
From 1970 on, the electronics industry replaced mercury batteries with lithium-iodine ones & silicone rubber enclosed crucial pacemaker components. Pacemakers gained programmable use, allowing doctors to adjust the device to the patient’s clinical needs. Read the Pace Maker Evolution.
Sydney’s Mark Cowley Lidwill Foundation was established in 2007, to promote and support the world-leading scientific research in cardiac electro-physiology. Thank you Sydney, my alma mater.
From 1970 on, the electronics industry replaced mercury batteries with lithium-iodine ones & silicone rubber enclosed crucial pacemaker components. Pacemakers gained programmable use, allowing doctors to adjust the device to the patient’s clinical needs. Read the Pace Maker Evolution.
Sydney’s Mark Cowley Lidwill Foundation was established in 2007, to promote and support the world-leading scientific research in cardiac electro-physiology. Thank you Sydney, my alma mater.
Guest blogger: Dr Joe