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In 1958, the world's first transvenous pacemaker system was developed and used at Montefiore Medical Center by cardiac surgeon Seymour Furman, MD, in collaboration with Doris J.W. Escher, MD, to restart a stopped heart during surgery and keep it beating until the normal rhythm returned. Over time, the device became portable and soon became implantable.

The pacemaker is now a small device implanted beneath the skin near the collarbone. Once implanted, it will monitor the heartbeat and emit an electrical impulse when the beat slows beyond an acceptable level.

A pacemaker is inserted if an electrophysiology study shows evidence of a slow pulse and if other treatments have not been able to improve the irregular heart rhythm. Some examples of heart rate and rhythm problems for which a pacemaker might be used include:

  • Bradycardia – a condition in which the heart beats too slowly
  • Tachy-brady syndrome – characterized by alternating fast and slow heart beats
  • Heart block – a condition in which the electrical signal is delayed or blocked after leaving the SA node; there are several types of heart blocks

Biventricular Pacing

Biventricular pacing is a therapy to treat heart failure in patients with altered electrical conduction. Although conventional pacemakers are inserted through a vein under the clavicle, biventricular pacemakers require the placement of pacing leads on both the right and left sides of the heart.


Montefiore physicians continue to make advances when it comes to the insertion of pacemakers. Dr. Joseph J. DeRose, Jr., performed the first robotic biventricular pacemaker insertion in the world and has the greatest experience with this procedure worldwide.

In addition, Montefiore is among the first medical centers in New York City to offer a pacemaker designed, tested and approved by the Food and Drug Administration for safe use in the magnetic resonance imaging (MRI) environment. The breakthrough technology makes it possible for patients with implantable pacemakers to undergo MRI scans.


Patients who receive any pacemaker must make sure it continues to work properly. Regularly scheduled appointments allow a physician using a special computer, called a programmer, to review the pacemaker's activity and adjust the settings when needed, thus ensuring the patient maintains a healthy heart rhythm.