Alois Langer

In 1972 Langer was hired by a company in Pittsburgh called Medrad Inc to work on the ICD project. The company president, Dr. Steve Heilman, had previously met with Baltimore cardiologist Dr. Michael Mirowski to discuss the possibility of developing the ICD. Mirowski had already patented the device and needed a company which would perfect it and manufacture it. Medrad took up the challenge of developing the ICD. Given Langer’s experience in electrocardiographic analysis and electrical engineering he was placed as the chief biomedical engineer of the ICD team. The fourth and last member of the initial team was Baltimore cardiopulmonary researcher Morton Mower.

As the engineering member of the ICD team, Langer was tasked with the design portion of development. He constructed both the miniature circuits on board as well as the mechanical packaging of the ICD. One of the time consuming tasks that Langer faced was the design of the electrode. This electrode needed to be reliable because it was the connection between the heart and the device that controlled all monitoring and defibrillation capabilities, however it also needed to be medically safe since it was being inserted into the body. Langer also had to design a battery that would power the device for several years without failing or causing any immune response in the body.

By 1976, Langer and the team had finished designing the device and started the rigorous and extensive testing process. For the next four years the ICT underwent animal models testing, design reviews, and other tests to verify that the device would indeed work. In 1980 the device was first implanted into a human subject at Johns Hopkins University. Langer was present in the operating room with the ICD device in hand; ready to be implanted into the first human. He was to test the device within the sterilized container just before it was to be implanted. Incidentally when he handed over the device to the nurse, it she lost control and dropped the device on the floor. Luckily Langer had brought duplicate for such incidents implanted this second copy successfully. Weeks later the team tested the device by inducing a potentially fatal arrhythmia. The defibrillator “took about 30-plus seconds or so” to restart the patient’s heart, says Heilman. Attending physicians were seconds away from giving up and jump-starting the heart with shock paddles when finally, says Heilman, “the device kicked in and did shock and did correct the rhythm.” By its completion, the ICD had 25+ patents.

Next, the device was adapted so that it could be used for patients at home. The product worked in a manner similar to home alarm systems. Cardiac data was acquired by the unit worn on the patient and continuously transmitted wirelessly to a Tele-Link unit located next to the telephone. The Tele-Link system is preprogrammed with various cardiac event criteria, and if it detects any such criteria on the patient, it immediately transmits the electrocardiogram (ECG) to a remote monitoring location. At the monitoring location the ECG is analyzed and action is taken within 15–20 seconds. The system even allowed for the patient’s physician to dial in and request recent cardiac recordings. Langer is credited as the inventor of this home cardiac monitoring service, referred to as Telemetry @ Home.

In 1996, Langer flew to Tempe, Arizona for the Super Bowl XXX in order to demonstrate the HEARTrac system. Langer set up the device on Myron Cope, the famous sports broadcaster for the game, in order to see “just how excited Cope gets during the big games”. The ECG from Cope was transmitted live to a cardiologist in Pittsburgh, who monitored it and provided feedback. The demonstration was proclaimed as a technological victory for Langer and his company Cardiac Telecom.