EDITORIAL
100
years of electro-
cardiography; who was Willem Einthoven? (1860-i1927) W illem Einthoven was born in Semarang w w (Netherlands Indies) in 1860. His father Jacob was a military physician who died when Willem was 6 years old. In 1870 his mother, Louise de Vogel, repatriated to the Netherlands and started her residence in Utrecht. In 1879 Willem entered the University of Utrecht as a medical student. During this period he was one of the founders of the 'Utrechtse Studenten Roeivereniging Triton' (Students' Rowing Club, figures 1 and 2) ofwhich he became an honorary member. After being assistant to the famous ophthalmologist H. Snellen Sr. (who linked his name to the famous Snellen eyetables, also grandfather ofthe late Herman Snellen, one of the first cardiologists in the Netherlands) in Figure 1. Willem Einithoven: the first Dutch eye hospital 'Gasthuis voor Oog- foundingfather URSIRowing lijders', he worked together with the physiologist F. Club Triton (1880). C. Donders, under whose guidance he wrote his PhD thesis (cum laude) in 1885 entitled 'Stereoscopie door kleurverschil' (Stereoscopy through difference in colour). In the same year, at the age of only 25 years, he was appointed Professor of Physiology and Histology at Leiden University as successor of Professor A. Heynsius. His inaugural address was entitled 'De leer der specifieke energieen' (The theory of specific energies). In 1905-1906 Einthoven took the position ofVice-Chancellor (Rector Magnificus) at Leiden University. His annual university lecture (Diesrede) on 8 February 1906 was entitled 'The significance of electrophysiology as a component ofthe theory ofcourses oflife' (Over de betekenis der electrofysiologie als een onderdeel van de leer der levensrichtingen). Initially Einthoven's personal research in Leiden concerned the two fields that he had become familiar with in Donders laboratory, i.e. vision and respiration. In 1892 Einthoven published his most important respiratory research, which was on the experimental proof of bronchial constriction by vagal stimulation (Uber die Wirkung der Bronchialmuskeln nach einer neuen Methode untersucht, und uber Asthma nervosum, On . the function of the bronchial Figure 2. Willem Einthoven: winning teama, USR muscles investigated by a new Triton (1883) (secondfrom the left).
Nctherlands Heart Journal, Volume 10, Number 7/8, August 2002
301
Editorial
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method, and on nervous asthma). At that time Einthoven's brother-inlaw Willem de Vogel came to work in the physiological laboratory in Leiden. De Vogel started to study electrical action currents in the hearts offrogs, rabbits and a dog. In the meantime, Einthoven occupied himself with the analysis and improvements in the device used by Wailer (Lippman's capillary electrometer). This investigation finally led Einthoven to develop the string galvanometer. Although the principles ofthe galvanometer were known and published by others, Einthoven's string galvanometer was the first device to allow the precise recording ofthe electrocardiogam. In 1901 Einthoven reported the construction ofthe string galvanometer. In 1902 and 1903 Einthoven published more details and the first electrocardiograms. The system of standardisation by Einthoven was completed in 1908 and adopted almost universally. However Einthoven's most influential paper had yet to come. This paper (Uber die Richtung und die manifeste Grosse der Potential Schwankungen im menschlichen Herzen und uber den Einfluss der Herzlage auf die Form de Electrokardiogramms, Pflugers Arch Ges Physiol 1913;150:275- Figure 3. Laboratory of Pbysiology, Leiden 315) described the scheme of the University. equilateral triangle and can be considered to be the start ofvector cardiography. Since then, the string galvanometer has led numerous investigators to study function and diseases of the heart. The laboratory (figure 3) at Leiden became a place of pilgrimage, visited by scientists from all over the world. In 1924 Einthoven was awarded the Nobel Prize for Physiology and Medicine. In 1927 Willem Einthoven died of abdominal cancer.
I
Hundred years have gone by since the Einthoven's first publications on the human electrocardiogram. Despite his own dassification ofbeing 'only a very ordinary little professor, who is not equal to the task he has set himself' (letter to his brother in 1896), Einthoven played a critical role by providing numerous researchers with the tools to record electrical currents from the heart. It is now unimaginable that research and patient care could be carried out without the possibility of recording electrical currents from the heart. Much has been clarified during the past hundred years. Not only different conduction disturbances and cardiac arrhythmias have been studied and described in detail, ionic mechanisms and more recently the genetics behind different arrhythmias and conduction disorders are being unravelled in a dramatic momentum. Furthermore, the development of catheter-based ablation techniques and surgical methods to treat arrhythmias resulted in a dramatic change in the prognosis of many patients. The Figure 4. Plrofessor Wilkem introduction of electrical devices to treat Einthoven, one of his last either slow or fast heart arrhythmias also pictuiwwithh"igs~nature atdthe improved the quality of life and life expectancy of many patients. bottom. l. |
302
Nctherlands Heart Journal, Volumc 10, Number 7/8, August 2002
r>:itox;-'*~14}
Editoral
The Einthoven 2002 meeting in Leiden, which was held from 9 to 11 June, was a great success in terms offaculty (more than 100 experts in the field), scientific quality, and audience (over 500 attendees). The meeting perpetuated the dynamic power of Einthoven who has put his electrical footprint in the hearts ofthose individuals with a keen interest in electrophysiology, providing unsurpassed knowledge of the hearts of patients with suspected or known cardiovascular disease.
E 2 ~ ~ ~ ~ ~ ~ ~ ~ M ii.'C>.z
Let us finish with one of Einthoven's quotes, which proved to be filfilled more than he could possibly have foreseen (recorded when his cooperation with the clinician Nolen at Leiden ended):
'Nolen will ultimately make money out of this, people will demand an electrocardiogram!'u
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M.J. Schalij, E.E. van der Wall, Department of Cardiology, Leiden University Medical Centre, Leiden.
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100
years of electro-
cardiography; who was Willem Einthoven? (1860-i1927) W illem Einthoven was born in Semarang w w (Netherlands Indies) in 1860. His father Jacob was a military physician who died when Willem was 6 years old. In 1870 his mother, Louise de Vogel, repatriated to the Netherlands and started her residence in Utrecht. In 1879 Willem entered the University of Utrecht as a medical student. During this period he was one of the founders of the 'Utrechtse Studenten Roeivereniging Triton' (Students' Rowing Club, figures 1 and 2) ofwhich he became an honorary member. After being assistant to the famous ophthalmologist H. Snellen Sr. (who linked his name to the famous Snellen eyetables, also grandfather ofthe late Herman Snellen, one of the first cardiologists in the Netherlands) in Figure 1. Willem Einithoven: the first Dutch eye hospital 'Gasthuis voor Oog- foundingfather URSIRowing lijders', he worked together with the physiologist F. Club Triton (1880). C. Donders, under whose guidance he wrote his PhD thesis (cum laude) in 1885 entitled 'Stereoscopie door kleurverschil' (Stereoscopy through difference in colour). In the same year, at the age of only 25 years, he was appointed Professor of Physiology and Histology at Leiden University as successor of Professor A. Heynsius. His inaugural address was entitled 'De leer der specifieke energieen' (The theory of specific energies). In 1905-1906 Einthoven took the position ofVice-Chancellor (Rector Magnificus) at Leiden University. His annual university lecture (Diesrede) on 8 February 1906 was entitled 'The significance of electrophysiology as a component ofthe theory ofcourses oflife' (Over de betekenis der electrofysiologie als een onderdeel van de leer der levensrichtingen). Initially Einthoven's personal research in Leiden concerned the two fields that he had become familiar with in Donders laboratory, i.e. vision and respiration. In 1892 Einthoven published his most important respiratory research, which was on the experimental proof of bronchial constriction by vagal stimulation (Uber die Wirkung der Bronchialmuskeln nach einer neuen Methode untersucht, und uber Asthma nervosum, On . the function of the bronchial Figure 2. Willem Einthoven: winning teama, USR muscles investigated by a new Triton (1883) (secondfrom the left).
Nctherlands Heart Journal, Volume 10, Number 7/8, August 2002
301
Editorial
8g.-fXS,a>_s.+j=,.¢1'J2:a: :...,*y?-'1.s:iS_;e[..U6w:'.S.,-4i'^:s ._ .:
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i,-,,L,jL fijji
. . 7 w '+. #'i.i t: ::....: 2.::::
i-E,;L '-d. t;.i
:'.'-". '.'ie-?;*ii...tw: '.:.L ..:..:.... s3LL ;|$
_telli .
_1p_s_
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"1..s: *'\ .: ,__ .._ _
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method, and on nervous asthma). At that time Einthoven's brother-inlaw Willem de Vogel came to work in the physiological laboratory in Leiden. De Vogel started to study electrical action currents in the hearts offrogs, rabbits and a dog. In the meantime, Einthoven occupied himself with the analysis and improvements in the device used by Wailer (Lippman's capillary electrometer). This investigation finally led Einthoven to develop the string galvanometer. Although the principles ofthe galvanometer were known and published by others, Einthoven's string galvanometer was the first device to allow the precise recording ofthe electrocardiogam. In 1901 Einthoven reported the construction ofthe string galvanometer. In 1902 and 1903 Einthoven published more details and the first electrocardiograms. The system of standardisation by Einthoven was completed in 1908 and adopted almost universally. However Einthoven's most influential paper had yet to come. This paper (Uber die Richtung und die manifeste Grosse der Potential Schwankungen im menschlichen Herzen und uber den Einfluss der Herzlage auf die Form de Electrokardiogramms, Pflugers Arch Ges Physiol 1913;150:275- Figure 3. Laboratory of Pbysiology, Leiden 315) described the scheme of the University. equilateral triangle and can be considered to be the start ofvector cardiography. Since then, the string galvanometer has led numerous investigators to study function and diseases of the heart. The laboratory (figure 3) at Leiden became a place of pilgrimage, visited by scientists from all over the world. In 1924 Einthoven was awarded the Nobel Prize for Physiology and Medicine. In 1927 Willem Einthoven died of abdominal cancer.
I
Hundred years have gone by since the Einthoven's first publications on the human electrocardiogram. Despite his own dassification ofbeing 'only a very ordinary little professor, who is not equal to the task he has set himself' (letter to his brother in 1896), Einthoven played a critical role by providing numerous researchers with the tools to record electrical currents from the heart. It is now unimaginable that research and patient care could be carried out without the possibility of recording electrical currents from the heart. Much has been clarified during the past hundred years. Not only different conduction disturbances and cardiac arrhythmias have been studied and described in detail, ionic mechanisms and more recently the genetics behind different arrhythmias and conduction disorders are being unravelled in a dramatic momentum. Furthermore, the development of catheter-based ablation techniques and surgical methods to treat arrhythmias resulted in a dramatic change in the prognosis of many patients. The Figure 4. Plrofessor Wilkem introduction of electrical devices to treat Einthoven, one of his last either slow or fast heart arrhythmias also pictuiwwithh"igs~nature atdthe improved the quality of life and life expectancy of many patients. bottom. l. |
302
Nctherlands Heart Journal, Volumc 10, Number 7/8, August 2002
r>:itox;-'*~14}
Editoral
The Einthoven 2002 meeting in Leiden, which was held from 9 to 11 June, was a great success in terms offaculty (more than 100 experts in the field), scientific quality, and audience (over 500 attendees). The meeting perpetuated the dynamic power of Einthoven who has put his electrical footprint in the hearts ofthose individuals with a keen interest in electrophysiology, providing unsurpassed knowledge of the hearts of patients with suspected or known cardiovascular disease.
E 2 ~ ~ ~ ~ ~ ~ ~ ~ M ii.'C>.z
Let us finish with one of Einthoven's quotes, which proved to be filfilled more than he could possibly have foreseen (recorded when his cooperation with the clinician Nolen at Leiden ended):
'Nolen will ultimately make money out of this, people will demand an electrocardiogram!'u
=
listu
M.J. Schalij, E.E. van der Wall, Department of Cardiology, Leiden University Medical Centre, Leiden.
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