TL;DR: The origins of this evolving technology date back to the early 20th century, when Willem Einthoven, a Dutch physiologist, developed the first electrocardiograph and can be regarded as the first clinician scientist to develop and systematically apply a technique that is very similar to telemedicine in the modern sense.
Abstract: 100 years of telemedicine
Although hard to believe, this year we celebrate the 100th anniversary of telemedicine. The term telemedicine was coined in the 1970s by the American Thomas Bird and, literally translated, means “healing at a distance” (from Latin “medicus” and Greek “tele”). However, the origins of this evolving technology date back to the early 20th century, when Willem Einthoven, a Dutch physiologist, developed the first electrocardiograph in his laboratory in Leiden. With the use of a string galvanometer and telephone wires, he recorded the electrical cardiac signals of patients in a hospital 1½ km away. He stated: “Where there is a link, actual and figurative, between laboratory and hospital, and collaboration between physiologist and clinician, each remaining master in his territory, there one may fruitfully utilize these new electrical methods of research”. Einthoven’s electrocardiograph was very large but over the years was transformed into a mobile or even portable monitoring device. Nevertheless, he can be regarded as the first clinician scientist to develop and systematically apply a technique that is very similar to telemedicine in the modern sense. The results of his experiments were published in 1906.1 During the 1920s, Norwegian doctors provided advice for sick ship crew members at sea via radio link. In 1967, Bird and colleagues established an audiovisual microwave circuit between the Massachusetts General Hospital in Boston, USA, and the nearby Logan Airport. They conducted and evaluated >1000 medical consultations for airport employees and travellers who were ill.2 Since then, the number of scientific studies relating to telehealth has steadily increased, and many countries have launched their own electronic health (e-health) programmes, which combine medical informatics, public health and business. Telemedicine constitutes a small part of e-health and is particularly suitable for large geographical areas with a sparse, underserved population. Examples are …
TL;DR: The history of the electrocardiograph is reviewed, with a focus on Willem Einthoven's quest to make the device a practical clinical instrument in the diagnosis of cardiac abnormalities.
Abstract: Willem Einthoven (1860–1927), known as the creator of the electrocardiograph, won a Nobel Prize in 1924 for his contributions to the field of electrocardiography He was dedicated to research and learning
In developing the electrocardiograph, Einthoven built on the work of earlier physiologists who had studied the electrical mechanisms of the heart Each earlier invention proved important by contributing concepts and knowledge that would shape Einthoven's device Herein, we review the history of the electrocardiograph, with a focus on Willem Einthoven's quest to make the device a practical clinical instrument in the diagnosis of cardiac abnormalities
TL;DR: It may be appropriate now to review the principal contributors to the early development of the field and the critical role of one piece of equipment, the string galvanometer, and to celebrate the 100th anniversary of electrocardiography.
Abstract: IN 1987, we will celebrate the 100th anniversary of electrocardiography.1 It may be appropriate now to review the principal contributors to the early development of the field and the critical role of one piece of equipment, the string galvanometer. The recording from the body surface of electrical potentials generated by the heart was first described in 1887,1 but early electrocardiographic instruments, which were called "electrometers," were not practical. They were delicate and inconvenient, and they had inherent distortion.2 It was only after the introduction of the sensitive and more convenient string galvanometer that clinical electrocardiography was launched. The string galvanometer . . .
TL;DR: Recording of the electrocardiogram by string galvanometer evolved a century ago from wide-ranging advances in physiology, physics, and engineering to become a fundamental tool for the investigation of the heart.
TL;DR: The historical development of the ECG and its limitations as a diagnostic tool for AMI is reviewed, and recent research into higher-resolution technologies for real-time cardiac monitoring, and how they may impact on chest pain management is highlighted.
Abstract: A century has passed since Einthoven published his description of the human electrocardiogram (ECG), recorded using a string galvanometer. The basic principles of this technique have remained unchanged, and it has revolutionized the diagnosis and management of cardiac pathology. At present, its sensitivity in diagnosing life-threatening myocardial infarction and ischaemia is inferior to that of biochemical markers. However, the ECG monitors cardiac function in real time, while biochemical assays can delay the diagnosis of acute myocardial infarction (AMI) and treatments that need to be delivered promptly. We review the historical development of the ECG and its limitations as a diagnostic tool for AMI, and highlight recent research into higher-resolution technologies for real-time cardiac monitoring, and how they may impact on chest pain management. Many distinguished scientists and clinicians have devoted their life's work to the use and understanding of the technique. This short review will merely highlight some of the more important contributions.
The electrical activity of the heart was an incidental finding of Kolliker and Muller in 1856. 1 When a frog sciatic nerve/gastrocenemius preparation fell onto an isolated frog heart, both muscles contracted synchronously, suggesting that the heart generates electrical impulses. This activity was directly recorded and visualized using a Lippmann capillary electrometer by the British physiologist John Burdon Sanderson. 2 In 1887, Augustus Desire Waller used this technique to show that cardiac electrical potentials could be recorded via the limbs and directly from the chest of intact animals and humans. 3 The electrical activity preceded the heart's contraction, excluding an artefact caused by ‘a mechanical alteration of contact between the electrodes of the chest wall caused by the heart's impulse’. However, the clinical importance of his recordings was overlooked.
Inspired by a demonstration by Waller, the Dutch physiologist Willem Einthoven began to develop capillary electrometer technology. This …
Address correspondence to Dr N. Herring, Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, Sherrington Building, Parks Road, Oxford OX1 3PT. email: neilherring{at}doctors.org.uk