[History of cardiac pacemaker therapy in Germany].

Cardiac pacemaker therapy began with successful stimulation of human hearts already in the first half of the 20th century. Complete implantation of a pacemaker by the cardiac surgeon Åke Senning on October 8, 1958 at the Karolinska Hospital in Stockholm is considered the actual birth of today's pacemaker therapy. The first pacemaker implantation in Germany was performed by Hans-Joachim Sykosch on October 6, 1961 at the Surgical Clinic of the University of Düsseldorf. Two years later, the first implantation in East Germany (GDR) was carried out by Friedrich Flemming on September 2, 1963 at the Charité in East Berlin. The first pacemaker manufactured in West Germany arrived on the market 1963; East Germany started device production in 1978. In 1974, pacemaker therapy in West Germany showed a 50% survival rate after 6.3 years compared to < 1 year with drug therapy. After initially using bare metal wires, pacemaker leads have significantly improved in both quality and reliability. Development culminated in the leadless pacemaker. Battery development led to a variety of inventions: rechargeable pacemakers, biogalvanic cells, bioenergy sources, nuclear generators and lithium batteries, the latter ultimately prevailed. In the beginning, only fixed-rate ventricular pacemakers were available. Subsequently, systems adapted to physiological requirements were developed: on-demand pacemakers, atrial-based pacing and rate-adaptive systems. However, it was not until the return to direct stimulation of the conduction system that truly physiological stimulation of the heart became possible.