Centennial of the string galvanometer and the electrocardiogram

This article is a review of the history of the string galvanometer and of the electrocardiogram (ECG) on the occasion of the centennial of the instrument. Einthoven most likely developed the string galvanometer prior to 1901, the date of the first publication. The galvanometer made electrocardiography practical creating a new branch of medicine and even a new industry. In 1791 Galvani, in 1842 Mateucci and in 1855 Kolliker and Muller recorded, using the nerve muscle preparation, contraction of injured muscle, contraction of muscle when laid across a beating heart, and occasionally two contractions. In 1872 Lippmann introduced the capillary manometer. Using the capillary manometer Waller recorded for the first time from body surface voltage changes generated by the heart. Einthoven and Lewis dominated the early years of electrocardiography. The former made his contributions by 1913 while Lewis continued the studies of arrhythmias until 1920. The period following 1920 was influenced largely by Wilson. None did as much to advance ECG knowledge as did Wilson. The interest shifted to the theory of the ECG, abnormalities of wave form and of ECG leads. A major contribution of the ECG is in evaluation of ischemic heart disease and cardiac arrhythmias. Issues facing electrocardiography in the year 2000 include a shortage of experienced electrocardiographers, the advent of new noninvasive procedures and, paradoxically, wide acceptance of the ECG by the medical profession. The role of the computer in analysis of the clinical ECG is limited. The technique, while reasonably reliable for analysis of the normal tracing and some ECG waveforms, has serious limitations when applied to arrhythmias. The early hopes for "stand-alone" programs are yet to be realized.