From a laboratory to the wearables: a review on history and evolution of electrocardiogram / Del laboratorio a la práctica: una revisión sobre la historia y evolución del electrocardiograma

The development of electrocardiography, one of the top scientific breakthroughs of the 20th century, occurred in the field of cardiology. The history of the ECG began long before its invention, with the advent of the study of electricity in the medical field. The idea of electrophysiology and Waller's initial recording of the ‘electrogram’ encouraged Willem Einthoven to develop new string galvanometers and turn this remarkable physiologic occurrence into a vital clinical recording tool. It has progressed from Einthoven's innovation to wearable technology. In the first part of the 20th century, a number of inventive people achieved a remarkable succession of discoveries and advancements that led to the development of the 12-lead ECG as we know it today. It went further than that. The evolution of science and technology over the years has allowed for continual development in terms of usefulness, ranging from five operators to one operator meant to record the ECG trace, and mobility, ranging from around 300 Kg to roughly around 1 Kg. Electrocardiographs in minimized form now exist thanks to the modern era of digitalization. We will go over the significant processes in the development of the ECG in this article. (AU)

El desarrollo de la electrocardiografía, uno de los principales avances científicos del siglo XX, se produjo en el campo de la cardiología. La historia del ECG comenzó mucho antes de su invención, con el advenimiento del estudio de la electricidad en el campo médico. La idea de la electrofisiología y el registro inicial del "electrograma" de Waller animó a Willem Einthoven a desarrollar nuevos galvanómetros de hilo y convertir este acontecimiento fisiológico notable en una herramienta de registro clínico vital. Ha progresado desde la innovación de Einthoven hasta la tecnología portátil. En la primera parte del siglo XX, varias personas ingeniosas lograron una notable sucesión de descubrimientos y avances que condujeron al desarrollo del ECG de 12 derivaciones tal como lo conocemos hoy. Fue más allá que eso. La evolución de la ciencia y la tecnología a lo largo de los años ha permitido un desarrollo continuo en términos de utilidad, que va desde cinco operadores a un operador destinado a registrar el trazo de ECG, y la movilidad, que va desde alrededor de 300 kg hasta aproximadamente 1 kg. Los electrocardiógrafos en forma minimizada ahora existen gracias a la era moderna de la digitalización. Repasaremos los procesos significativos en el desarrollo del ECG en este artículo. (AU)

Gerbezius' Pulsus Mira Inconstantia and the First Descriptions of the Atrioventricular Block.

This article reconstructs the steps leading to the identification of the atrioventricular block, from its first descriptions to current studies, highlighting the roles of Arthur Keith (1866-1955) and Martin Flack (1882-1931), who contributed to establish the theoretic basis for electrocardiography.

James Herrick (1861-1954): Consultant physician and cardiologist.

In 1910, James Bryan Herrick published the first clinical and laboratory description of sickle cell anemia. Two years later, he published a case report on coronary thrombosis. Together, these case reports solidified his reputation as one of the premier diagnosticians of his generation. Now regarded as a central figure in the history of American medicine, Herrick played an integral role in the clinical adoption of the electrocardiograph and the professionalization of cardiology in the United States. Although a full decade passed before the medical profession recognized his clinical description of coronary thrombosis and myocardial infarction, it has had profound implications for cardiovascular medicine and prevention over the past hundred years. As a consultant physician, Herrick advocated in favor of incorporating chemistry and laboratory evaluation into clinical practice.

The History of Home Cardiorespiratory Monitoring.

Home cardiorespiratory monitoring has changed significantly since it was first introduced in the 1970s. It has improved from a simple alarm system to a sophisticated piece of equipment capable of monitoring the patient's electrocardiogram, respiratory effort, and oxygen saturations. In addition, the indications for using a monitor have also changed. The home monitor was initially used to reduce the incidence of sudden infant death syndrome (SIDS). Although there were several studies demonstrating the reduction of SIDS rates in communities where apnea programs existed, none was a prospective, double-blinded study or had adequate numbers to be clinically significant. Therefore, the American Academy of Pediatrics took the stance that monitors were not an effective way to reduce SIDS. However, when used appropriately, as part of a complete program (ie, the monitor is just one of many clinically based modalities), by a clinician with expertise in interpreting download tracings, home cardiorespiratory monitoring can be a useful, lifesaving, and economical tool to observe infants who are at increased risk of sudden death or increased morbidity secondary to intermittent hypoxia. [Pediatr Ann. 2017;46(8):e303-e308.].