In 1956, one wrong resistor sparked the discovery of the implantable pacemaker

While it may seem that most medical innovations are the result of planned and systematic procedures, many monumental inventions in the realm of medicine are the result of serendipity. One of these events took place in 1956, when an American engineer, by the name of Wilson Greatbatch, made a mistake while working in his laboratory. While trying to build a specific type of device, Greatbatch reached into a component box and, unknowingly, unlocked a device that would enable the technology to save the lives of many people by aiding the function of a failing heart.The device that Greatbatch was trying to build when the mistake happened was an oscillator that would record rapid heart rhythms. When the incorrect component was placed into a circuit, instead of facilitating the device to record sounds, it completely altered the usefulness of the mechanism.A mistake that produced a beatWhen the large resistor was inserted into the circuit, the circuit failed, broke, and began to smoke. What happened was that the circuit began to pulse a repeated pattern of electrical signals. To anyone else, the assembly appeared to be a failed construct. However, Greatbatch realised that the rhythmic signal that the mechanism was emitting was the pattern of a human heartbeat.The Smithsonian notes that Greatbatch made a connection and realised that the signalling mechanism could be used to stimulate a heart that is failing and unable to pulsate in a rhythmic pattern.Prior to breakthroughs in pacemaker technology, patients were required to carry large, cumbersome, and unpleasant devices. These early pacemakers delivered shocks by wire to devices strapped to a patient's body. The lucky patients were tethered to a wall outlet, while all other patients were at the mercy of the inevitable power outages. Greatbatch worked on making his small, battery-powered, and less painful version of the pacemaker pulse continually so that the patient could lead a normal life and travel. From lab pulse to implantable deviceHaving an electrical pulse and a working circuit was just the start of Greatbatch's advances. The next hurdle was the design. Greatbatch spent the next four years improving the design, sealing the device, and working with surgeons to improve the design.As recorded by the National Center for Biotechnology Information, in 1960, Greatbatch's hard work, along with many other breakthroughs, resulted in the first successful permanent pacemaker implantation in the United States. Greatbatch's pacemaker allowed the treatment of patients with a very serious Complete Heart Block. Greatbatch's invention and the early implantable pacemakers changed the standard of care for serious heart conditions.The technology behind the blocking oscillator design, a misidentified resistor, has influenced many early pacemaker circuits and contributed to later, more reliable pulse generators used widely in pacemakers. Reliability is considered a hallmark of a system, indicating more than a coincidental, short-lived solution.Why was this accident particularly notable?Unlike many errors seen throughout the history of science, which often yield little to nothing of value, the Greatbatch story is notable for the synergy of a misidentified resistor, diagnostic, and engineering skills. While the insight was not the mistake, it was the insight to recognise what the mistake illuminated. He realised what failing hearts required. It was the art of science and engineering that provided the failing heart regularity, reliability, repeatability, and pacing.The onset of the story of pacemakers shows the value of engineering and medical practice. It can be the routine lab error, seen by an experienced and trained practitioner as a latent opportunity, that provides the tipping point for a medical revolution.