A Concise History of the ECG

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

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.

1850-1900

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 1885 Chauveau was the first to describe complete heart block in a horse while observing ventricular beats without movement of the atrial auricles.

In 1887 the English physiologist Augustus D. Waller from Londen published the first human electrocardiogram. He used a capillar-electrometer. [4][5]

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.

1900-1950

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. [6]

1950-2000

2000-

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

References

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

    [Dubois]
  2. Hurst JW. Naming of the waves in the ECG, with a brief account of their genesis. Circulation. 1998 Nov 3;98(18):1937-42. DOI:10.1161/01.cir.98.18.1937 | PubMed ID:9799216 | HubMed [Hurst]
  3. Hoffa M, Ludwig C. 1850. Einige neue versuche uber herzbewegung. Zeitschrift Rationelle Medizin, 9: 107-144

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

    [Waller]
  5. Waller AD. Introductory Address on The Electromotive Properties of the Human Heart. Brit. Med J, 1888;2:751-754

    [Waller2]
  6. Einthoven W. Le telecardiogramme. Arch Int de Physiol 1906;4:132-164

    [Einthoven]
  7. Chauveau MA. De La Dissociation Du Rythme Auriculaire et du Rythme Ventriculaire. Rev. de Méd. Tome V. - Mars 1885: 161-173.

    [Chauveau]
  8. Einthoven W. Über die Form des menschlichen Electrocardiogramms. Pfügers Archiv maart 1895, pagina 101-123

    [Einthoven2]
  9. 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

    [Marey]
  10. Márquez MF, Colín L, Guevara M, Iturralde P, and Hermosillo AG. Common electrocardiographic artifacts mimicking arrhythmias in ambulatory monitoring. Am Heart J. 2002 Aug;144(2):187-97. DOI:10.1067/mhj.2002.124047 | PubMed ID:12177632 | HubMed [Marquez]

All Medline abstracts: PubMed | HubMed