The history of electrical stimulation of the heart dates back to 1862 when Walsh discussed the possibility of causing the heart to contract through stimulation of the sympathetic nervous trunk by an induced current.4 By 1910, it was largely understood that the neuromuscular mechanism of the heart was electrically dependant. In 1932, Hyman used a needle electrode to carry stimulating current directly to heart muscle.5 Zoll accomplished the first successful clinical application of external cardiac pacing in 1952 by resuscitating two patients in asystole following bradycardia from a high-degree AV block.6 He concluded that external cardiac pacing was a safe and effective means of resuscitating ventricular standstill. Unfortunately, Zoll's devices caused significant chest pain, skeletal muscle spasm, superficial skin burns, and disrupted electrocardiographic patient monitoring.6 The quest for alternative pacing modalities continued with the refinement of the transesophageal technique, initially suggested by Zoll in 1952, and clinically demonstrated by Shafiroff and Linder in 1957.7 In 1958, Thevenet et al. reported the emergency use of a lumbar puncture needle introduced 5 mm into the myocardium, through which a conducting wire was introduced, to produce transthoracic cardiac pacing.8 In 1959, Furman and Robinson passed a transvenous wire catheter and successfully applied an electrical current to the endocardial surface of the right atrium.9 Transvenous pacing subsequently became the most widely accepted method of emergency cardiac pacing until the reemergence of Zoll with a modified external pacing system in 1981.10