A Concise History of the ECG

Willem Einthoven (1860-1927), the founder of the current ECG

ECG from Eindhoven's first publication. Pfügers Archiv March 1895, page 101-123

Einthoven's string-galvanometer, now in the Science Museum in Londen. The patient had to put his hands in salt baths to which the electrodes were connected. Image from the IEEE history society.

The last generation of ECG equipment. Image courtesy of General Electric

The history of the ECG goes back more than one and a half century

In 1843 Emil Du Bois-Reymond, a german physiologist, was the first to describe "action potentials" of muscular contraction. He used a highly sensitive galvanometer, which contained more than 5 km of wire. Du Bios Reymond named the different waves: "o" was the stable equilibrium and he was the first to use the p, q, r and s to describe the different waves. [1] However, in his excellent paper on the 'Naming of the waves in the ECG' Dr Hurst credits Einthoven for being the first to use PQRS and T.[2]

In 1850 M. Hoffa described how he could induce irregular contractions of the ventricles of doghearts by administering electrical shock. [3]

In 1887 the English physiologist Augustus D. Waller from Londen published the first human electrocardiogram. He used a capillar-electrometer. [4]

The dutchman Willem Einthoven (1860-1927) introduced in 1893 the term 'electrocardiogram'. He described in 1895 how he used a galvanometer to visualize the electrical activity of the heart. In 1924 he received the Nobelprize for his work on the ECG. He connected electrodes to a patienta showed the electrical difference between two electrodes on the galvanometer. We still now use the term: Einthovens'leads. The string galvanometer (see Image) was the first clinical instrument on the recording of an ECG.

In 1905 Einthoven recorded the first 'telecardiogram' from the hospital to his laboratoy 1.5 km away.

In 1906 Einthoven published the first article in which he described a series of abnormal ECGs: left- and right bundlebranchblock, left- and right atrialdilatation, the U wave, notching of the QRS complex, ventricular extrasystoles, bigemini, atrialflutter and total AV block. [5]

References

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1. Du Bois-Reymond, E. Untersuchungen über thierische Elektricität. Reimer, Berlin: 1848.

3. Hoffa M, Ludwig C. 1850. Einige neue versuche uber herzbewegung. Zeitschrift Rationelle Medizin, 9: 107-144

4. Waller AD. A demonstration on man of electromotive changes accompanying the heart's beat. J Physiol (London) 1887;8:229-234

5. Einthoven W. Le telecardiogramme. Arch Int de Physiol 1906;4:132-164

6. Einthoven W. Über die Form des menschlichen Electrocardiogramms. Pfügers Archiv maart 1895, pagina 101-123

7. Marey EJ. Des variations electriques des muscles et du couer en particulier etudies au moyen de l'electrometre de M Lippman. Compres Rendus Hebdomadaires des Seances de l'Acadamie des sciences 1876;82:975-977