For context, the 0.1 rem yearly dose to the patient is about 1/6th of the average background dose we all get every year.

This Pu-238 is the same stuff that's powering the Voyager probes and a few Mars rovers.

Note that it's not Pu-239, which is fissile nuclear fuel for chain reactions (power plants, bombs, etc.)

> Dose rates at the surface of the pacemaker are approximately 5 to 15 mrem per hour from the emitted gamma rays and neutrons.

Where are these gamma rays and neutrons coming from? The decay chain for Pu-238 is via alpha emission (Pu-238 -> U-234 -> Th-230 -> ...) which won't penetrate the casing.

For similar / further reading on historical pacemakers, check out https://www.implantable-device.com/category/implantable-comp... where David Prutchi has amassed what I think is a comprehensive history of pacemakers / neurostimulators ranging from these early atomic designs up through current day devices / companies.

More interesting to me is how this tech was programmed. There would have been some external unit to set parameters.

Pu-238 in this thing would cost $14K in today's prices!