FROM SATELLITES TO SAVING LIVES
Dr. Robert Fischell
When pacemakers were first developed nearly 50 years ago, the devices' limited battery life forced patients to undergo painful and debilitating surgeries every two years to ensure their devices had enough battery power to function properly. At the time, a two-year life expectancy for a pacemaker's battery was considered remarkable. But for Robert Fischell, ScD, this status quo was unacceptable. The nearly 200,000 patients that have pacemakers implanted every year can thank Dr. Fischell for helping to develop better pacemakers so that they can live healthier, more active lives. 1
PHYSICIST TO MEDICAL TECHNOLOGY INNOVATOR
Although trained as a physicist rather than a medical doctor, Dr. Fischell understood the importance of innovative medical technology. “Medical devices are particularly valuable because they can be very effective in
Pacemaker Facts
- Nearly 200,000 pacemakers are implanted in patients every year in the United States.
- When pacemakers were first invented, the battery life was only two years. Today, pacemaker batteries can last up to 10 years.
- Pacemakers today can also collect and store patient data so physicians can monitor how well the device is working.
the treatment of many human disorders,” said Dr. Fischell. With the same technology used to recharge the batteries in space satellites during the 1970s, Dr. Fischell, who at the time was working at The Johns Hopkins University Applied Physics Laboratory, created a pacemaker using the materials he had on hand in his lab, with a nickel cadmium battery that could be recharged without any additional procedures. Little did he know that this battery, which he designed simply because he saw a need to improve the lives of patients with pacemakers, would hurtle him into a new career as a medical technology innovator.
In the type of rechargeable battery Dr. Fischell was working on, an alternating current in an external coil creates a magnetic field which induces an alternating current in a secondary coil housed within the pacemaker. That internal alternating current then provides direct current power to charge the battery.2 This specialized battery is enclosed in a lightweight case that also contains a tiny computer, which sends electrical signals needed to pace the heart. Dr. Fischell's hermetically sealed, rechargeable pacemaker battery was a groundbreaking invention that has vastly improved patient outcomes and added value to the health care system. However, the development of this new technology did not happen overnight.
After conceptualizing and developing the new hermetically sealed pacemaker in the Applied Physics lab at Johns Hopkins, Dr. Fischell presented his idea to the surgical staff at the university's School of Medicine. Due to his well-established relationships at the university's medical school, the team was receptive to his ideas. Working together, the team found the perfect balance between creating a battery that was strong enough to last longer than any battery had before and one that was small enough to fit comfortably in the pacemaker. After some months of testing, the device was deemed ready to begin implantation tests. Together with the John Hopkins team, Dr. Fischell implanted the first hermetically sealed, rechargeable pacemaker in a laboratory dog in the early 1970s. The surgery was performed successfully on five laboratory dogs before the device was first implanted into a human two years later.
According to Dr. Fischell, “After the pacemaker was successfully implanted into a human, the manufacturing of the device was not difficult.” Dr. Fischell and the rest of the team from Johns Hopkins presented the pacemaker to the engineers at a device company's nickel cadmium battery division. By the time the team brought the device to the manufacturer, the physicians already had a firm grasp on what they wanted them to produce. The physicians carefully explained to the engineers why the specifications they outlined were important to the device's function within the human anatomy. The engineers were receptive to their plans, and after they reviewed the research that had already been done, they worked with Dr. Fischell to perform additional canine and human tests.
BECOMING THE STANDARD
Dr. Fischell's Medical Technology Inventions
- Invented the first implantable insulin pump, which helps diabetics better manage their condition.
- Co-invented the structure for an advanced drug-eluting stent designed for opening blocked arteries.
- Co-invented an implantable micro-computer that can sense precursors of epileptic seizures and prevent them from occurring.
- Co-invented an implantable pacemaker-sized computer that allows for the earliest possible detection of an oncoming heart attack.
In 1975, the manufacturer began producing and distributing the hermetically sealed device. Physicians received training on how to use the new pacemaker from the company and other physicians, and within a very short time, hermetically sealed pacemakers were embraced by doctors across the country as the new standard of care.
Since then, pacemaker technology has steadily advanced, as patient outcomes data and physician feedback have led to a number of enhancements that have resulted in increased benefits for patients. The battery that Dr. Fischell invented has been replaced by lithium batteries that can last as long as 10 years for present-day pacemakers. Current models include sophisticated sensors that can monitor and respond to changes within the patient's body. These models collect and store this data, and then send it out to the patient's physician using telemetry signals, to indicate how well the device is working. Pacemakers today are all hermetically sealed to prevent body fluids from causing failures of the electronic components. Even with these advances, the devices are much smaller than they were years ago. Many of these innovations were pioneered by Dr. Fischell.
NEW INNOVATIONS
In addition to following the evolution of his own inventions, Dr. Fischell has also helped fellow innovators with their latest inventions. “Engineers or MDs call me on average about once per quarter to ask advice on a new medical product that they are inventing,” said Dr. Fischell. “I try to help with these requests, and in at least one recent case, I told the MD that he was doing it wrong, I invented a better way to do what he said was needed, and we have now formed a company to make an improved treatment system for breast cancer.”
Over the years, Dr. Fischell has developed many medical devices that have changed the face of health care delivery, while saving and improving patients' lives. In addition to the rechargeable pacemaker, Dr. Fischell also invented the first implantable insulin pump more than 20 years ago to help diabetics manage their disease. Dr. Fischell is also the co-inventor of the structure for the drug-eluting stent, which has become a standard treatment option for opening clogged arteries.
Today, at age 77, Dr. Fischell sits on several boards at the University of Maryland, including the Board of Advisors for the College of Computer, Mathematical and Physical Sciences and the School of Engineering. He also remains very involved with the continuing development and improvement of all the technologies he helped create, particularly in the stenting field. He is also involved with more than seven device manufacturing companies, as a president, chairman or a member of the board, and remains committed to developing more innovative ways to improve patient care.
“Medical technology is of great importance to the health care system,” said Dr. Fischell. “It is of the utmost importance that future generations continue to focus on developing medical technology innovations.”
- Heart Center Online. Pacemaker. . (20 September 2006).
- Patent Storm. . (12 December 2006)