Professor Frank Pantridge

Inventor of the portable defibrillator

In the United Kingdom, 270,000 people suffer a heart attack each year, and a third of them die before reaching hospital. Frank Pantridge invented the portable defibrillator, which delivers a controlled electric shock to the heart and as a treatment for heart attack saves the lives of 40 per cent of under-65s it is used on. It can be stored in ambulances, ships, planes, etc, and can therefore be used with less delay and operated by amateurs. Used worldwide, it has saved thousands of lives. Pantridge is regarded as the father of emergency medicine, and he also did much to develop pre-hospital coronary care.

James Francis Pantridge, cardiologist: born Hillsborough, Co Down 3 October 1916; MC 1942; staff, Royal Victoria Hospital and Queen's University Belfast 1945-82, Honorary Professor of Cardiology 1982-2004; Research Fellow, University of Michigan 1948-49; Director, Regional Medical Cardiology Centre, Northern Ireland 1977-82; CBE 1978; died Hillsborough 26 December 2004.

In the United Kingdom, 270,000 people suffer a heart attack each year, and a third of them die before reaching hospital. Frank Pantridge invented the portable defibrillator, which delivers a controlled electric shock to the heart and as a treatment for heart attack saves the lives of 40 per cent of under-65s it is used on. It can be stored in ambulances, ships, planes, etc, and can therefore be used with less delay and operated by amateurs. Used worldwide, it has saved thousands of lives. Pantridge is regarded as the father of emergency medicine, and he also did much to develop pre-hospital coronary care.

James Frank Pantridge was born in Hillsborough, Co Down, in 1916, into a family of small landowners. His father died when he was 10. Problems with authority, which were to dog his life, started at an early age and he was expelled from several schools before completing his secondary education at Lisburn Friends' School.

Despite further clashes with authority he graduated in medicine near the top of his year and qualified as a doctor at Queen's University, Belfast, in 1939. He was given a coveted house job at the Royal Victoria Infirmary - known as the Vic - but left to enlist in the Army, although conscription was voluntary in Northern Ireland.

He was sent to Singapore and, having lost no time in falling out with his boss at the military hospital, was seconded to the Gordon Highlanders in Changi. He was awarded the Military Cross in 1942 with the citation:

This officer worked unceasingly under the most adverse conditions of continuous bombing and shelling and was an inspiring example to all with whom he came into contact. He was absolutely cool under the heaviest fire.

When Singapore fell on 1 February 1942 the order came to surrender. It is said that Pantridge, along with other medical officers, eased the death of men who were too badly injured to be evacuated. He spent the rest of the Second World War in the slave labour camps of the Burma-Siam railway, including some months in the Tanbaya death camp, where few survived.

Pantridge survived cardiac beriberi, where protein deficiency damages the heart, which is usually fatal, and which may have ignited his interest in heart disease. His experience in the prison camps undoubtedly scarred him mentally as well as physically. He was appalled at the Japanese guards' cruelty, and applauded Harry Truman's decision to drop the atomic bomb on Japan.

In 1945 Pantridge returned to Belfast and took the only job available to him, as a part-time lecturer in the university's anatomy department. He went on to research cardiac beriberi. Three years later he won a research fellowship to the University of Michigan, where he worked with the world's leading expert on the electrical measurement of heart disease, Frank Wilson, cardiologist to President Lyndon Johnson. Later, Pantridge's defibrillator was used on Johnson when he had a heart attack.

Pantridge returned again to Belfast in 1949 and was appointed physician at the Royal Victoria Hospital, known as the Vic. He brought with him the operation of mitral valvotomy, and was given the task of evaluating a huge backlog of patients with congenital or rheumatic heart disease for which surgery had become available. He had no interest in coronary artery disease.

One day in late 1960 or early 1961, the chief of medicine, Professor Graham Bull, suggested that it was important to get medical aid swiftly to heart- attack victims. Pantridge responded in his characteristic style:

This is yet another of the many idiotic ideas which emanate with monotonous regularity from the Professor of Medicine, who thinks it is possible to achieve immortality for patients with coronary artery disease.

Bull realised that defibrillation should be available where it occurred, which was at home, in the street, at work, or in an ambulance. Pantridge did a U-turn and went on to design the first portable defibrillator, in 1965. He installed it into an ambulance that was converted into a mobile coronary care unit, with trained staff to operate it. Within the first 15 months, he recorded 10 successful resuscitations and a 50 per cent long-term survival rate.

At 70kg, the weight of an average man, it wasn't all that portable, but, after the usual 10-15 years of scepticism, it was fitted into every UK ambulance in what came to be called the Pantridge Plan, and it saved lives. Belfast acquired a reputation as the best place in the world to have a heart attack. Later, Pantridge went on to refine the machine using a capacitor designed by Nasa, and it now weighs 3kg.

Pantridge argued that there should be one beside every fire extinguisher, as life was more important than property. Aware that it could be dangerous if misused, he incorporated a fail- safe mechanism that successfully identified a patient's heart rhythm and automatically decided whether a shock is necessary.

Frank Pantridge was awarded Fellowship of the Royal College of Physicians in 1957, and appointed CBE in 1978. He remained at the Vic until he retired in 1982, having established a cardiology unit with an international reputation. He opposed the introduction of coronary by-pass surgery, but later underwent it himself.

Pantridge was the author of The Acute Coronary Attack (1975) and an autobiography, An Unquiet Life (1989), published privately, which went into a fourth edition in 1995. He was an irascible man on a good day, often apoplectic, rode roughshod over his juniors, and was fond, perhaps too fond, of wining and dining. He would monopolise a conversation and walk away when he had said what he wanted. On one occasion he took a colleague out to dinner and next morning dictated a letter to their MP, William van Straubenzee, saying what a good chap Pantridge was, and asked the colleague to sign it.

Despite all this, he could be loyal, witty and generous. He deserved a knighthood and it was probably his cantankerousness that prevented it. America, in contrast, recognised his work. His friends thought that a good woman would sort him out, but he never married and became reclusive in his old age.

Caroline Richmond



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