Bernard Lown Inventions Information

Bernard Lown (born June 7, 1921) is the original developer of the direct current defibrillator and the cardioverter. Lown developed the direct current defibrillator for cardiac resuscitation and the cardioverter for correcting rapid disordered heart rhythms, and introduced a new use for the drug lidocaine to control heartbeat disturbances.

Throughout his medical career, Lown focused on two major medical challenges: the problem of sudden cardiac death and the role of psychological stress on the cardiovascular system. His investigations led to many medical break-throughs. Among these were the coronary care unit. His work made possible and safe much of modern cardiac surgery, as well as a host of other innovations. In 1985, Lown accepted the Nobel Peace Prize on behalf of the International Physicians for the Prevention of Nuclear War, an organization he co-founded with Soviet cardiologist Yevgeny Chazov, who later was Minister Of Health of the USSR.

Lown is currently Professor of Cardiology Emeritus at the Harvard T.H. Chan School of Public Health, and Senior Physician Emeritus at the Brigham and Women’s Hospital, Boston, Massachusetts. He is the founder of the Lown Cardiovascular Center and Lown Cardiovascular Research Foundation. He recently founded the Lown Institute, which aims to reform both the health care system and society.

Born to a Jewish family in Lithuania, the son of a rabbi. Bernard Lown emigrated to the United States at the age of 14.

Lown graduated summa cum laude from the University of Maine and received an M.D. from Johns Hopkins University School of Medicine in 1945. His medical training included Yale-New Haven Hospital (Yale University, New Haven, Connecticut); Montefiore Medical Center, Bronx, NY; and a cardiology fellowship at the Peter Bent Brigham Hospital (now Brigham and Women’s Hospital, in Boston). His mentor in cardiology was the renowned clinical cardiologist, Samuel A. Levine.

Lown helped raise international medical awareness of sudden cardiac death as a leading cause of mortality in the developed world. Based on patient observations, Lown concluded that sudden cardiac death was reversible and survivable, and that people who were successfully resuscitated could have a near normal life expectancy.

Working with his mentor Samuel A. Levine, Lown realized that the high mortality of a heart attack, then 35 percent, was most likely due to rigorous bed rest. Patients remained completely recumbent for six or more weeks. A major complication of bed rest was pulmonary embolism, which accounted for a significant part of the mortality. Although Lown encountered enormous opposition and hostility among doctors to the so-called "chair treatment," in 81 patients so treated, mortality was reduced by two thirds. Once the work was published, the chair treatment was rapidly adopted and hospitalizations were reduced to several days. Untold lives were saved by getting patients out of bed.

Until the 1950s, ventricular fibrillation of the heart could only be treated with drug therapy. In 1956 American cardiologist Paul Zoll described resuscitations during open-heart surgery and later after sudden cardiac death by means of an alternating current (AC) electric shock, derived from a wall socket. AC current was untested as to its safety and efficacy and could cause death. In 1959, Lown demonstrated that AC was injurious to the heart and could be lethal. These investigations were conducted in the Department of Nutrition at the Harvard School of Public Health. The work was supported by Professor Frederick Stare, chairman of the Department of Nutrition.

To find a safer method of cardiac resuscitation, Lown enlisted the help of Baruch Berkowitz, an electrical engineer employed by American Optical Company (AO). In their experimental work, Lown focused on two objectives: safety and efficacy. Alternating current caused burns in skeletal and heart muscle also inducing atrial as well as ventricular fibrillation in a large majority of the animal experiments.

During a year of intense experimentation, in 1961 Lown and coworkers proved that a specific direct current (DC) waveform consistently reversed ventricular fibrillation, restoring a normal heart beat without injuring heart or skeletal muscle. This became widely known as the "Lown waveform." It facilitated the worldwide acceptance of the defibrillator and cardioverter and improved survival of patients with coronary heart disease.

The DC defibrillator provided a new approach for resuscitating patients. It also paved the way for new possibilities in cardiac surgery. The Lown clinical group were the first to use the defibrillator and cardioverter at Peter Bent Brigham Hospital. Donald B. Effler, was the first cardiac surgeon to use the DC defibrillator in 1962 at the Cleveland Clinic. According to Effler, this advance made possible modern cardiac surgery. Indeed, in 1967, Rene Favoloro performed what is regarded as the first coronary artery bypass operation in Effler’s surgical department at Cleveland Clinic. DC defibrillation provided a safe way to restore a normal heart rhythm during the surgical bypass of obstructed coronary arteries.

Lown went on to investigate the possibilities of the defibrillator to treat non-life-threatening tachycardias. He discovered that timing the electrical discharge outside the heart’s brief vulnerable period of 0.03 seconds in duration prevented ventricular fibrillation or sudden cardiac death. He called this method of timed DC discharge "Cardioversion." The cardioverter and DC defibrillator were especially valuable in coronary care units, when patients are hospitalized when most susceptible to sudden cardiac death and other potentially malignant arrhythmias.

In addition to advancing medical technology, Lown discovered new applications for two drugs that were widely used for cardiac problems: digitalis and lidocaine. Until the 1950s, digitalis poisoning was a major cause of fatality among patients with congestive heart failure. During a medical residency at the Montefiore Hospital in New York City, Lown demonstrated the critical role of potassium in determining the safe use of digitalis. His discovery led to abandonment of long acting digitalis drugs like digitoxin. Instead, the short acting digitalis glycoside gained universal acceptance. It also focused medical attention on potassium loss with the use of various diuretics.

In 1964, Lown introduced a new use for the drug lidocaine to control ventricular disordered heart rhythms. Lidocaine was also used in coronary units to prevent the need for resuscitation. Previously, lidocaine was used almost exclusively by dentists as an anesthetic agent.

In 1957, Lown was concerned with how to visualize an atherosclerotic aortic plaque, which occurs in the big coronary vessels that supply nutrients to the heart muscle. This would, he hoped, lead to discovering how to treat and prevent heart attack and sudden cardiac death. A discussion with a close friend, Elias Snitzer, a physicist at Massachusetts Institute of Technology led to an introduction to Michael Polanyi, a physicist with American Optical Company. At the time, Polanyi was working on fiber optics. Lown received a grant from the Hartford Foundation to pursue fiber optics. However, optical technology, at the time, was inadequate. This line of research was discontinued. Lown's work did show that, with fiber optics, it was possible to measure oxygen saturation in dogs, and determine the cardiac output in humans.

Paradoxically, when Lown submitted two abstracts to the World Cardiology Conference in Mexico in 1964, one on the defibrillator and cardioversion, and one dealing with fiber optics, the former was rejected and the latter accepted.

In early 1961, Lown called together a group of physicians from Boston’s teaching hospitals to address the mounting threat of nuclear war between the USSR and the USA. This political subject had not been addressed previously by physicians in the United States. The new organization called itself Physicians for Social Responsibility (PSR).

Among the activist participants were Jack Geiger and Victor W. Sidel. By the end of 1961, the group had drafted five research articles about the medical consequences of a ten megaton nuclear attack on the city of Boston, a magnitude considered both possible and likely by the U.S. military. The series, "The Medical Consequences of Thermonuclear War", was published as a symposium in the New England Journal of Medicine in May 1962.

These articles encouraged anti-nuclear medical movements worldwide. Additionally, they helped pass the Limited Test Ban Treaty in the U.S. Senate.

Lown was also involved in organizing COR, Committee of Responsibility to Save War Burned and War Injured Children. of which he was a leading member. This organization aimed to bring injured and burned Vietnamese children for treatment in the United States, in order "to bring the war home."

Complete article available at this page.