Before we begin a serious study of 12 lead EKG interpretation, left us first take a moment to give credit to those earliest of pioneers who conducted groundbreaking research that led to the modern 12 lead EKG.
In this article, we will discuss Luigi Galvani, Kollicker and Mueller, Ludwig and Waller, and finally, Willem Einthoven.
Luigi Galvani (1737 - 1798)
This physicist and physician lived in Bologna, Italy.
Early in the 16th century, the relationship between the nerves and the muscles was not understood. In fact, it wasn't always obvious that the nerves carried electrical impulses to stimulate muscles. It was only in 1790 that Luigi Galvani discovered this connection. In front of an audience of stunned scientists, he made detached frog legs dance upon the application of an electrical current.
Rudolf von Kollicker (1817 - 1905)
Johannes Peter Mueller (1801 - 1858)
Mueller was a German physiologist who studied at the University of Bonn. He later moved to Humbolt University of Berlin, where he was the chair of anatomy and physiology. Kollicker was Swiss, but studied in Berlin, as a pupil of Mueller. Over 50 years after Galvani, in 1855, Kollicker and Mueller demonstrated that the heart beats due to electrical stimulus. They did this by laying electrodes over top of a beating heart and then connecting the electrodes to detached frog legs. Each time that the heart beat, the frog legs moved.
Augustus D. Waller (1856 - 1922)
Carl Friedrich Willem Ludwig (1816 - 1895)
Carl Ludwig was appointed professor of physiology at the University of Leipzig in 1865. Augustus Waller was his student. At Aberdeen University, Waller studied medicine. He became a lecturer in physiology at St Mary's hospital. Not only did he have a laboratory at home, but his wife, children, and pet bulldogs participated in his experiments. In 1887, he used a capillary electrometer to record the first electrocardiogram. He attached a photographic film to a slowly moving toy train. He did not think, however, that this information would be useful in hospitals.
Tests conducted during this time were done through vivisection - open heart surgery on living animals. It wasn't until the 1880s that Ludwig and Waller showed that you could contact the heart's electrical signal not only by making direct contact with the heart, but by placing electrodes on the skin.
Willem Einthoven (1860 - 1927)
Finally, in 1904, Willem Einthoven was able to make the graph of the electrical signals originating at the heart. He won the Nobel Prize in Medicine in 1924 for his invention which he called the electrokardiogram. Einthoven was a Dutch doctor and physiologist. He studied at the University of Utrecht and became a professor at the University of Leiden in 1886. His original machine required 5 people to operate and weighed 500 lb. He named the deflections that he saw using the letters P,Q,R,S, and T. He also showed that this machine could be used to diagnose heart abnormalities.
This first EKG used only limb leads. It wasn't until later in the 20th century that the chest leads were added to create the 12 lead EKG.
As you continue on to further your study of EKG interpretation, remember these pioneers who made this critical measurement possible.
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