Bernard Lown

Bernard Lown

Bernard Lown (1921 – ) American cardiologist, activist and inventor.

The original developer of the DC defibrillator and the cardioverter (1961)

Accepted the Nobel Peace Prize in 1985 on behalf of the International Physicians for the Prevention of Nuclear War (IPPNW) which he co-founded

Despite much opposition, Lown instituted early mobilisation post coronary thrombosis (the ‘armchair treatment’), which significantly reduced hospital length of stay and reducing early mortality by 2/3.

Advocated the use of digitalis (rather than digitoxin) and demonstrated the critical role of potassium reducing risk of toxicity (a major issue at the time); and the use of IV lidocaine (lignocaine) to reduce post-infarct arrhythmias.

Prominent advocate for public health – founder of SATELLIFE and ProCor


Biography

  • Born 7 June 1921 Utena, Lithuania
  • 1935 – Emigrated to the United States at the age of 13
  • 1942 – Received B.A. (summa cum laude) in the classics from the University of Maine
  • 1945 – Received M.D. from Johns Hopkins University
  • 1945-46 – Assistant in pathology, Yale University-New Haven Hospital
  • 1947-48 – Medical intern, Jewish Hospital, New York City

Peter Bent Brigham Hospital, Boston:

  • 1950-53 – Research Fellow in cardiology
  • 1955-56 – Assistant in medicine
  • 1956-58 – Director of ‘Samuel A. Levine Cardiovascular Research Laboratory’
  • 1965-1974 – Director ‘Samuel A. Levine Coronary Care Unit’
  • 1973-81 – Physician; Senior physician, since 1982

Harvard University, Boston:

  • 1961-67 – Assistant Professor of Medicine, School of Public Health
  • 1967-73 – Associate Professor of Cardiology
  • 1974 onwards – Professor of Cardiology
  • 1961 onwards– Director of Cardiovascular Research Laboratory, School Public Health

Consultant in cardiology:

  • 1963-77 – Newton-Wellesley Hospital,Massachusetts
  • 1963-94 – Beth Israel Hospital,Boston
  • 1964-82 – Children’s Hospital Medical Center, Boston
  • 1985 – Accepted Nobel Peace Prize (see below)
  • 1987 – Founded ‘SATELLIFE’ to provide health workers in developing nations free information services through satellite and Internet technologies
  • 1997 – Founded ‘ProCor’ to promote cardiovascular health using electronic communication technologies
  • Currently – Professor of Cardiology Emeritus at the Harvard T.H. Chan School of Public Health

Key Medical Attributions

Nobel Peace Prize

1961 – Physicians for Social Responsibility (PSR) to address the mounting threat of nuclear war between the USSR and the USA. Drafted research articles about the medical consequences of a ten megaton nuclear attack on the city of Boston – ‘The Medical Consequences of Thermonuclear War

1980 – International Physicians for the Prevention of Nuclear War (IPPNW) in the face of the mounting nuclear threat that followed USSR’s invasion of Afghanistan and the election of Ronald Reagan. Working closely with Soviet cardiologist Dr. Evgeni Chazov (later to become later USSR Minister Of Health) the movement grew exponentially [IPPNW Milestones]

1985 – Lown accepted the Nobel Peace Prize on behalf of the IPPNW


DC Defibrillator and cardioversion

1956 – Paul Zoll performed cardiac resuscitation using alternating current (AC) electric to manage VF/VT during heart surgery, and later in the event of sudden cardiac arrest [N Engl J Med 1956; 254:727-732]

1959 – In animal experiments, Lown working with Baruch Berkowitz (of the American Optical Company) found that AC caused burns to skeletal and heart muscle; could induce atrial and ventricular fibrillation and was potentially lethal.

1961 – Lown found that a specific direct current (DC) waveform consistently reversed VF, restoring a normal heart beat without injuring heart or skeletal muscle. He noted that the incidence of VF was 10x more frequent after AC than DC cardioversion. Additionally he isolated the ‘vulnerable period’ immediately following the T wave during ventricular depolarization when a DC shock could induce VF.

1961 – Lown’s machine was the first to be used successfully on a humans at Peter Bent Brigham Hospital. [JAMA 1962;182(November):548—55.]

1962 – Lown then developed a method of timed DC discharge he called ‘Cardioversion‘ to provide an a safe and effective electrical discharge outwith the heart’s brief 0.03s ‘vulnerable period‘.


Medical Eponyms

  • Lown–Ganong–Levine syndrome – Pre-excitation syndrome with short PR interval (A-V conduction time), normal QRS duration and paroxysms of tachycardia: Lown B – Ganong WFLevine SA
  • Lown Cardiovascular Center (founded 1947)
  • Lown Institute (formerly the Lown Cardiovascular Research Foundation), founded in 1973 and renamed in 2012 to reflect the focus of medical overuse and underuse
  • The Bernard Lown Scholars in Cardiovascular Health Program at Harvard T.H. Chan School of Public health (established 2008)

Major Publications

  • Levine SA, Lown B. The “chair” treatment of acute thrombosis. Trans Assoc Am Physicians. 1951;64:316-27. [PMID 14884265]
  • Levine SA, Lown B. “Armchair” treatment of acute coronary thrombosis. J Am Med Assoc. 1952 Apr 19;148(16):1365-9. [PMID 14907380]
  • Lown B, Ganong WF, Levine SA. The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action. Circulation. 1952 May;5(5):693-706. [PMID 14926053]
  • Levine HD, Vazifdar JP, Lown B, Merrill JP. Tent-shaped T waves of normal amplitude in potassium intoxication. [PMID 14902682]
  • Lown B, Levine SA. Current concepts in digitalis therapy. N Engl J Med. 1954 May 13;250(19):819-32 [PMID 13165905]
  • Lown B, Lown B, Neuman J, Amarasingham B, Berkovits BV. Comparison of alternating current with direct current electroshock across the closed chest. Am J Cardiol. 1962 Aug;10:223-33. [PMID 14466975]
  • Lown B. Defibrillation and cardioversion. Cardiovasc Res. 2002 Aug 1;55(2):220-4. [PMID 12123757]
  • Lown B, Amarasingham R, Neuman J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA. 1962 Nov 3;182:548-55. [PMID 13931298]
  • Lown B, Perloth MG, Kaidbey S, Abe T, Harken DE. “Cardioversion” of atrial fibrillation. A report on the treatment of 65 episodes in 50 patients. [PMID 13931297]
  • Lown B. The Lost Art of Healing: Practicing Compassion in Medicine. Houghton Mifflin. 1996
  • Lown B. Practicing the art while mastering the science. Harbinger Medical Press. 2000
  • Lown B. Prescription for Survival: A Doctor’s Journey to End Nuclear Madness. Berrett-Koehler. 2008

References


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eponym

the person behind the name

Doctor in Australia. Keen interest in internal medicine, medical education, and medical history.

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