Biography

Norman A. Roth, the electrical engineer who developed the first pacemaker lead implantable by thoracotomy for chronic epicardial cardiac pacing, died of cancer at his home in suburban Minneapolis on July 24, 1997. He was 66.

Roth was an early employee at Medtronic, Inc. (Minneapolis, MN). In 1958, the company introduced a transistorized, battery-powered external pulse generator for temporary pacing, with myocardial wires, for post surgical AV block. Mycocardial wires frequently were associated with progressively rising stimulation threshold. Roth recognized that with an appropriate lead, this generator could pace the heart for weeks or months. In his design (1959), the insulated lead terminated in a silicon rubber patch or "platform" measuring 1.5

by 2.5 cm from which protruded two spikes, making this the first clinically effective bipolar electrode. The surgeon would insert the spikes into the myocardium and stabilize the platform with sutures through six tiny holes around its perimeter.

In April 1959, surgeon Samuel W. Hunter implanted the "Hunter-Roth" electrode in a 72-year-old man experiencing repeated Stokes-Adams attacks. The patient recovered and survived until 1966 with t he bipolar electrode connected through a skin port to the external generator. On the basis of this case, surgeon William M. Chardack and engineer Wilson Greatbatch chose the Hunter-Roth electrode for long term use with their first implantable pulse generator (June 1960).

Though superseded in 1961 by new designs, the Hunter-Roth electrode holds an important place in the development of implantable cardiac pacing. Norman Roth helped redefine pacing from a temporary treatment for patients who had undergone open heart surgery to long-term arrhythmia management.

In 1988, Roth himself developed complete heart block and received an implanted pacemaker. One year later, the transvenous lead on his unit was recalled and replaced.

- Kirk Jeffrey, Ph.D.
  Carleton College
  Northfield, Minnesota

3016 December 1997, Part I PACE, Vol. 20