In 1895 His discovered the underlying cardiac condition which was delineated when he experimentally produced heart block. He suggested that a lesion of the atrioven-tricular (AV) bundle was responsible for blocking the conduction of electrical impulses from the atrium to the ventricles (see Fig. 1). His further documented the condition in a patient with heart block associated with syncope and a recording was made with Sir James Mackenzie’s polygraph.
In 1913, Sir Thomas Lewis recorded the electrocardio¬gram of a patient with complete heart block.
The world of cardiac pacing had to wait until Seymour Furman, in 1958, illustrated that transvenous endocardial cardiac pacing with a pacemaker electrode placed in the right ventricle corrected the electrical problem and was a safe technique. The first small clinical trials described the successful use of transvenous temporary cardiac pacing. This technique could not have evolved without cardiac catheterization skills and techniques that began in Germany in his arm into the right atrium. Then in the late forties the established role of catheterization was taken further by Cournand and others.
The first electrode used on preliminary dog studies was a diagnostic Cournand cardiac catheter with a steel wire as a conductor soldered distally to a bit of tinfoil wrapped around the tip of the catheter. A Swedish physician, Ake Senning, performed a permanent implant that year using a Siemens pacemaker.

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