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Chapter 11: Electrocardiography

William E. DeTurk; Lawrence P. Cahalin; Moacir Fernandes de Godoy; Rosangela Akemi Hoshi

INTRODUCTION

The electrocardiogram (ECG) is a graphic representation of the depolarization of the heart. The physiology of depolarization of the heart is described in Chapter 5, and the particular pathways for conduction of the wave of depolarization are shown in Fig. 11-3. The ECG has undergone tremendous development and use since it was first applied to humans in 1887 by Augustus D. Waller.1 A brief history of the ECG is presented in Table 11-1.1-6

TABLE 11-1aHistory of the Electrocardiogram
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TABLE 11-1 History of the Electrocardiogram
Date Historical Figure Contribution
1842 Carlo Matteucci First to find that an electric current accompanies each heart beat
1843 Emil Dubois-Reymond First to find that an “action potential” accompanies muscular contraction
1872 Gabriel Lippmann Invented a capillary electrometer (a thin glass tube with a mercury column beneath sulfuric acid—mercury was observed to move with an action potential)
1876 E. J. Marey First to record a frog’s electrical activity using a capillary electrometer
1878 John Burden Sanderson Frederick Page First to describe that the heart’s electrical activity consists of two phases, which later were labeled as the QRS and T waves
1887 Augustus D. Waller Published the first human ECG
1890 G. J. Burch Devised a mathematical correction for the sluggish fluctuations of the electrometer
1891 William Bayliss Improved the electrometer and identified three Edward Starling phases of the heart’s electrical activity, which were later called the P, QRS, and T waves
1893 Willem Einthoven Introduced the term electrocardiogram
1895 Willem Einthoven Improved the electrometer and identified five distinct deflections, which he names P, Q, R, S, and T waves
1897 Clement Ader Developed an amplification system called a string galvanometer
1901 Willem Einthoven Modified the string galvanometer to produce ECGs
1905 Willem Einthoven Began transmitting ECGs via telephone cable from the hospital to his laboratory approximately 1.5 km awaya
1906 Willem Einthoven Published the first report on normal and abnormal ECGs2
1910 Walter James Horatio Williams Published the first American review of electrocardiography and also transmitted ECGs from one location to another3a
1912 Willem Einthoven Published the first report on an equilateral triangle formed by his standard limb leads (I, II, and III), which was later called Einthoven’s triangle4
1920 Harold Pardee Published the first ECG of an acute myocardial infarction5
1924 Willem Einthoven Wins the Nobel Prize for inventing the electrocardiograph
1928 A.C. Ernstine and S.A. Levine First to use vacuum tubes to apply the ECG, rather than the string galvanometer
1928 Frank Sanborn Developed the first portable ECG machine weighing 50 lb
1932 Charles Wolferth and Francis Wood First to introduce and describe chest leads (V1 through V6)
1938 American Heart Association and Canadian General Standards Board Published ECG standards6
1942 Emmanuel Goldberger First to introduce and describe augmented limb leads (aVR, aVL, aVF), which together ...

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