A Concise History of the ECG

Author(s)	J.S.S.G. de Jong
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some notes about authorship

Parts of this overview were provided by Dean Jenkins and Stephen Gerred and their ECGlibary.com

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

1600-1800

1600. William Gilbert, Physician to Queen Elizabeth I, President of the Royal College of Physicians, and creator of the 'magnetic philosophy' introduces the term 'electrica' for objects (insulators) that hold static electricity. He derived the word from the Greek for amber (electra). It was known from ancient times that amber when rubbed could lift light materials. Gilbert added other examples such as sulphur and was describing what would later be known as 'static electricity' to distinguish it from the more noble magnetic force which he saw as part of a philosophy to destroy forever the prevailing Aristotlean view of matter. [1]

1649. Sir Thomas Browne, Physician, whilst writing to dispel popular ignorance in many matters, is the first to use the word 'electricity'. Browne calls the attractive force "Electricity, that is, a power to attract strawes or light bodies, and convert the needle freely placed". (He is also the first to use the word 'computer' - referring to people who compute calendars.)[2]

1660. Otto Von Guericke builds the first static electricity generator.

1662. The work of Rene Descartes, French Philosopher, is published (after his death) and explains human movement in terms of the complex mechanical interaction of threads, pores, passages and 'animal spirits'. He had worked on his ideas in the 1630s but had abandoned publication because of the persecution of other radical thinkers such as Galileo. William Harvey had developed similar ideas but they were never published. [3]

1664. Jan Swammerdam, a Dutchman, disproves Descartes' mechanistic theory of animal motion by removing the heart of a living frog and showing that it was still able to swim. On removing the brain all movement stopped (which would be in keeping with Descarte's theory) but then, when the frog was dissected and a severed nerve end stimulated with a scalpel the muscles twitched. This proved that movement of a muscle could occur without any connection to the brain and therefore the transmission of 'animal spirits' was not necessary.

Swammerdam's ideas were not widely known and his work was not published until after his death. However, he wrote many letters and his friend, Nicolaus Steno, did attack the Cartesian ideas in a lecture in Paris in 1665. Boerhaave published Swammerdam's 'Book of Nature' in the 1730s which was translated into English in 1758.

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. [4] 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.[5]

In 1850 M. Hoffa described how he could induce irregular contractions of the ventricles of doghearts by administering electrical shock. [6]

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. [7][8]

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

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

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

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.

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. [9]

2000-

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

External Links

• ECG history on ECGlibrary.com
• History of electrophysiology on the website of the Heart Rhythm Society

References

1. Gilbert W. De Magnete, magneticisique corporibus, et de magno magnete tellure. 1600

2. Browne, Sir Thomas. Pseudodoxia Epidemica: Or, enquiries Into Very Many Received Tenents, and Commonly Presumed Truths. 1646: Bk II, Ch. 1. London

3. Descartes R. De Homine (Treatise of Man); 1662: Moyardum & leffen, Leiden.

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

5. 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 |

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

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

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

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

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

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

12. 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

13. 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 |