Pioneering pacemakers

People with a very slow or irregular heartbeat may need a pacemaker to help them maintain a normal heartbeat. Pacemakers work by sending electrical impulses that stimulate your heart to beat at the correct speed or rhythm. Around 50,000 people are fitted with a pacemaker in the UK each year.

In the 1950s cardiologist Dr Aubrey Leatham and his technician Geoffrey Davies worked to develop a prototype pacemaker. In 1960 they implanted the UK's first internal pacemaker, in a 65-year-old who had suffered repeated life-threatening heart rhythm disturbances. But many challenges were associated with the early versions of pacemakers. The first prototypes needed relatively high voltages to pace the heart that were intolerable for patients. Dr Leatham and Mr Davies overcame this problem by creating devices that had better contact with the heart muscle, so that lower voltages could be used. Even so, early pacemakers were still bulky and required a traumatic operation to open the chest, in order to sew electrodes directly onto the heart.

Almost as soon as the BHF was formed, we began funding Dr Leatham’s research into the development of pacemaker technology at St. George’s Hospital. Within five years, Dr Leatham’s team had successfully treated several hundreds of patients.

Pacemakers today

Their pioneering work has helped pave the way for the miniature, sophisticated pacemaker devices that today can transform people’s quality of life.

Dr Leatham’s original pacemaker had to be charged externally through an induction coil strapped around the body, which required a weekly overnight stay in hospital. Pacemakers today have a built-in battery that lasts for years and can also collect and store information about how a patient’s heart is beating. They are fitted under the skin, with leads implanted into the heart.

The next generation of pacemakers are so tiny they can fit inside the heart itself, and don’t need any leads.

Modern pacemakers are also able to offer cardiac resynchronisation that helps the pumping chambers of the heart to beat in time with each other, which can help large numbers of people with heart failure.

This progress is built on the foundations of Dr Leatham’s research. Dr Leatham, who was born in 1920, lived till 2012 after having a pacemaker fitted in 2009, experiencing first-hand the huge advances that followed his pioneering research transforming the duration and quality of countless lives.

Implantable cardioverter defibrillator (ICD)

Some modern pacemakers are now combined with a life-saving ICD (implantable cardioverter defibrillator) that can deliver electric shocks to kick-start the heart if someone experiences dangerous abnormal heart rhythms.

Traditionally, ICDs are implanted in the chest and the wires attach to the heart, a procedure that requires invasive surgery. More recently, a new ICD has been developed called the subcutaneous ICD (S-ICD), which is implanted under the skin, below the armpit and close to the chest. The S-ICD is less invasive, avoiding the risks and complications of surgery.

The development of the S-ICD was made possible due to a series of discoveries made by BHF-funded researchers Professors Andrew Grace and Christopher Huang at the University of Cambridge.

Their research from 2002 to 2019, part-funded by the BHF, increased understanding of the genetic changes that can cause abnormal heart rhythms and was used as a platform to develop the first S-ICD. The device was developed by a biotech company who used the underpinning research to file a patent in 2004. Since 2013, this device has been used to treat thousands of patients across over 40 countries.

Last updated 9th September 2023