MIROWSKI, MICHEL

MIROWSKI, MICHEL (1924–1990), doctor and co-inventor of the implantable defibrillator. Born in Poland, Mirowski survived the Nazi Holocaust as a teenager and was left without family. He immigrated to Lyon, France, to study medicine. He completed his postdoctoral studies in Israel at Tel Hashomer Hospital and fellowships with Professor Demetrio Sodi Pallares in Mexico City and with Dr. Helen Taussig at Johns Hopkins in the U.S. In 1963, he returned to Israel and became the chief cardiologist at Asaf Harofe Hospital, where he focused his research on abnormal heart rhythms.

In the late 1960s, his former mentor at Tel Hashomer Hospital and chief of medicine, Dr. Harry Heller, died of recurrent tachyarrhythmias. This event marked a turning point in Mirowski's career. Realizing that patients like Heller cannot stay indefinitely in hospitals, and inspired by the recent development of the implantable pacemaker, Mirowski conceived of a small implantable device that would monitor the heart continuously and deliver an appropriate electrical shock to patients in response to life-threatening abnormal heart rhythms (ventricular tachyarrhythmias). Mirowski hoped that the hundreds of thousands of people who succumbed annually to abnormal heart rhythms could be saved by such a device. However, the technology of the time rendered the concept of miniaturizing a large table-top external defibrillator with no monitoring capabilities untenable.

Unable to find resources to pursue his idea in Israel, Mirowski returned to Baltimore in 1968 to direct the new Coronary Care Unit at Sinai Hospital. It was within a year that his team developed the first prototype, making him the pioneer cardiologist who invented the implantable defibrillator (id). The first surgical implant of the defibrillator occurred in 1980 at the Johns Hopkins Hospital.

He led the way for the clinical use of the implantable defibrillator despite enormous obstacles from within the medical profession, and in defiance of many leading cardiologists in the field who said the implantable defibrillator had no clinical utility. It was his steadfast commitment to the concept of the implantable defibrillator and the goal of introducing it into clinical cardiology in his lifetime that allowed him to see some of the fruits of his vision and his labors before his premature death in 1990 from multiple myeloma.

Since the 1980s, many new generations of ids have been developed, all based on Mirowski's original concept and work. Hundreds of thousands of lives have been saved by ids worldwide, and they have revolutionized the therapy for malignant tachyarrhythmia and heart failure. Mirowski's life story demonstrates the importance of unfettered scientific inquiry in medical advance. His favorite quote was, "The bumps in the road are not bumps. They are the road."

[Ariella M. Rosengard and

Dan Gilon (2^nd ed.)]