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EKG History

Who Invented the Electrocardiogram?

The electrocardiogram is the most common test used in the practice of Cardiology, and it has been around for a long time now – it was invented in 1901, and was the first time that modern technology, using electricity, was used in Medicine.  The electrocardiogram, the EKG, is an essential tool to understand the normal and abnormal function of the human heart, and it was invented almost accident.

In 1889, a young doctor from Holland named Willem Einthoven was attending a medical conference in Basal, Switzerland when he saw what he first thought might be just a circus stunt on the stage.  A doctor from England, Augustus Waller, was showing the audience his bulldog Jimmy, who was in sitting comfortably with his paws in buckets of salt water.  On his limbs, Waller attached electrodes running to a device that was recording electrical signals from Jimmy – signals from each heartbeat.

The audience was amazed but then Waller had been showing off his dog and his toy all over Europe for a few years.  Dr. Waller thought his display of the heartbeat of a dog was just a curiosity, not a potential tool to use in the practice of Medicine. But Dr. Einthoven had a spark of creative genius that day.

Einthoven was convinced that he could create a much better machine that Waller’s primitive device, and spent the next 12 years working on his brand new tool – the electrocardiogram.  By 1901 Einthoven was ready to use his EKG machine in real live patients, setting up his laboratory next to a hospital, and transmitting the signals to a recording device in the hospital over telephone wires.  Einthoven’s EKG machine weighed over 600 pounds!

P wave – electrical contraction of the atria, the upper chambers of the heart

QRS complex – electrical contraction of the ventricles, the lower chambers of the heart

T wave – “repolarization” wave of the ventricles

 

Over the next decade, Einthoven was able to show the normal rhythm of the heart, how the heart chambers each had different EKG signals, and also how the EKG pattern of the heartbeat changed when patients had palpitations – now called cardiac arrhythmias.  The EKG machine became used all over Europe, and then the United States to diagnose heart problems.

In the 1920’s, other doctors discovered that the EKG would change its appearance dramatically when patients had chest pain from coronary artery blockages due to atherosclerosis, and when they suffered a myocardial infarction, a heart attack. For the first time, a definite diagnosis of the most common form of heart disease, atherosclerosis, could be made.

Eventually, in the 1930’s it was discovered that physical exercise in people with coronary artery disease could not only bring on the pain known as angina pectoris, but that the EKG could change from normal to abnormal – the stress test was born.

The mechanics the EKG machines used today are basically the same as Einthoven first used, when he placed a thin wire of silver-plated quartz between two electromagnets, ran an electrical current through the wire, and then attached electrodes to the arms, legs, and chest of people. Fortunately, modern machines don’t weight 600 pounds!

Willem Einthoven won the Nobel Prize in Medicine in 1921 for his invention of the EKG machine.  All Nobel Prizes are markers of great achievements, and although there have since been many other Nobel Prize winners for their work in cardiac medicine, no prize was more well-deserved than the one given to Willem Einthoven. It is impossible to imaging the medical specialty of Cardiology without the EKG.

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