Dr. Agustin Castellanos, who helped develop the modern pacemaker, dies at 89

Dr. Agustin Castellanos, the only child of an international authority on children’s heart conditions who was twice nominated for the Nobel Prize, made his own mark in cardiovascular research.

His nearly 60 years of study and accomplishment would lead the University of Miami professor of medicine to co-develop pacemakers that are now common.

At 63, in 1990, he also found himself on the Colombian island of Gorgona, where he joined an international team of scientists to shoot darts at humpback whales to obtain electrocardiograms useful for human heart research. For cardiologists, the view afforded by a whale’s heart, which is structurally similar to a human’s but 4,500 times larger, was akin to studying a human heart through a microscope but with more detail. The group hoped to learn how to treat arrythmias that can cause heart attacks.

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By the time Castellanos, Tino to friends, retired in 2011, he’d racked up a slew of honors from institutions including UM, the American Medical Association and the Cuban Medical Association in Exile.

“Dr. Castellanos contributed immeasurably to the field of electrocardiography and clinical bedside electrophysiology, and will be remembered nationally and internationally for all that he contributed. He was the intellectual idea-person who stimulated his colleagues and students to think creatively,” said Dr. Robert Myerburg, professor of medicine and physiology at the University of Miami Miller School of Medicine.

Castellanos, born in Havana to pediatric cardiologist Dr. Agustin W. Castellanos and his wife Angela Sanchez de Castellanos, died Aug. 9. He had Parkinson’s disease and atrial fibrillation, said Maria Castellanos, his wife of nearly 66 years. Castellanos was 89.

The quest for medical knowledge begun in Cuba in 1925 by his father, who developed in the late 1930s the angiocardiogram used today to detect heart disease, turned into a dynasty.

Castellanos graduated from the University of Havana School of Medicine in 1953. His early research, begun in Havana and continued when he emigrated to the United States in 1960, focused on electrical forces generated by an infant’s heart.

He completed an internship at UM/Jackson and joined its faculty as an instructor in medicine in 1962. He earned recognition for his clinical cardiovascular research focusing on electrocardiography — recording the electrical activity of the heart — and cardiac electrophysiology — the study of the electrical properties of cells and tissues.

In 1965, along with fellow UM cardiologist, the late Dr. Louis Lemberg, he co-developed the implantable “demand” pacemaker, now known as the VVI pacemaker. These devices, along with another of his developments, the AV sequential or bifocal pacemaker, gained traction because they pulse only when the heart fails to beat on its own. Earlier pacemakers tended to cause arrhythmias because they competed with the heart’s beats.

“There was no greater teacher than Tino Castellanos,” Myerburg said. “His former trainees during his years on the faculty benefited greatly from his knowledge and teaching skills.”

Among those who have followed Castellanos: his sons Agustin M. Castellanos, a neurologist in Palm Beach Gardens, and Daniel Castellanos, a psychiatrist in Miami. Grandson Daniel Castellanos is a pediatric cardiologist in Houston. Granddaughter Natalie Castellanos is a lawyer and assistant professor — at Florida International University Herbert Wertheim College of Medicine.

“I strayed from that path … but fulfilled the family destiny,” she said. “I’m in the teaching and healthcare world. Other cousins are educators. Without even knowing it we all have gone into service work or teaching and I really do circle back to his influence.”

Castellanos, she said, didn’t push his family into the medical field. “His contributions were as significant as his father’s but he was never one to boast. There was not an expectation to do it. It trickled down.”

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When the senior Castellanos died in 2000 at 98, Agustin Castellanos spoke to the Miami Herald of his father’s influence.

“He opened small clinics in predominantly poor areas where he established a network of doctors to work with children. If you ask me what is the most important lesson I learned from him, it’s that he received more internal satisfaction from treating the needy and the poor than from treating the wealthy. And I’ve passed this on to my sons.”

Castellanos’ survivors include his wife Maria; his children Agustin, Daniel and Susana Castellanos and Lina Varona; and seven grandchildren. Services were held. Donations marked to the Dr. Agustin Castellanos Endowed Lecture Series can be made to the University of Miami Miller School of Medicine.

This story was originally published August 17, 2017 at 5:38 PM with the headline "Dr. Agustin Castellanos, who helped develop the modern pacemaker, dies at 89."