During a heavy December 2000 snowstorm, Dave Peterson was sweeping the floor of his Star Prairie, Wisconsin, auto repair shop when he collapsed, writhing in pain. “Bang! All of a sudden, down I went,” Peterson recalls. “I crawled over to the phone and called my wife.”

Local doctors stabilized Peterson until the storm lifted and an ambulance could transport him 43 miles to St. Paul’s United Hospital. There, cardiologist Dr. Stuart Adler of the St. Paul Heart Clinic diagnosed Peterson with atrioventricular (AV) block, a condition in which the electrical signal that regulates the heartbeat fails to transmit.

Adler implanted a dual-chamber pacemaker made by Guidant, an Indianapolis-based company, since purchased by Massachusetts-based Boston Scientific, whose cardiac rhythm management headquarters is in Arden Hills. In a dual-chamber pacemaker, wires called leads carry electrical pulses from the pulse generator to the right atrium and right ventricle to help coordinate the timing of the contractions between two of the heart’s four chambers.

That pacemaker helped Peterson for eight years. “But I still felt like I was running out of energy,” he says. Considered state of the art at the time, Peterson’s pacemaker had the ability to detect when a person is exerting himself and adjust the pacing accordingly, instead of simply maintaining a steady pace. This enabled the pacemaker to pace the heart at a faster rate when Peterson was walking or moving about.

But as Adler notes, “It’s fairly easy to see how that might not be a perfect fit for people who like to ride a stationary bike. The device has no idea they are working hard.” It also might not be a perfect fit for someone like Peterson when he is sweeping or working under a car.

So Peterson received a new pacing device that incorporates technological advances developed over the past decade. Though pacemakers have evolved and continue to evolve, two things haven’t changed about the pacemaker industry: It’s highly competitive, and it’s dominated by Minnesota-based companies.

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