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Today we almost take EKG machines for granted. Place a few leads on the body, flip a few switches, and out pops red graph paper with a series of black squiggly tracings that can show us what is happening with the heart. But this essential piece of medical technology has existed as we know it for less than a century. In 1924, “…for discovery of the mechanism of the electrocardiogram,” Dutch scientist Willem Einthoven received the Nobel prize in Physiology or Medicine.

We know that electrical impulses cause the heart muscle to contract in a wave of chain reactions, pumping blood to the lungs and the rest of the body. Those electrical impulses originate in cells known as pacemaker cells. The amount of electricity produced is very small, measured in millivolts. One of the challenges Einthoven faced was measuring electricity in this small amount, and from the outside of the body. As the electric wave travels through bone and the tissues of the body, it grows weaker.

Early experiments using frogs were able to measure the electrical activity of the heart only by placing the measuring equipment directly on the heart. Obviously, researchers did not want to have to go inside the human body to conduct such measurements. Einthoven used a string galvanometer to improve the sensitivity of the EKG, mostly to avoid complex mathematical calculations. He published his first detailed description of his instrument in 1909. His original research is still the fundamental basis of electrocardiography and we still use his terminology today. And although the string galvanometer has been supplanted by EKG machines using amplification techniques, EKGs using the string galvanometer remained the standard of references even to recent times.

Born in 1860 in Semarang, Einthoven was the son of an army medical doctor, and entered the University of Utrecth in Holland in 1878 hoping to follow in his father’s footsteps. In 1908 his interests turned toward electrocardiology.

In his Nobel speech, Einthoven wrote, “A new chapter has been opened in the study of heart diseases, not by the work of a single investigator, but by that of many talented men, who have not been influenced in their work by political boundaries and, distributed over the whole surface of the earth, have devoted their powers to an ideal purpose, the advance of knowledge by which, finally, suffering mankind is helped.”

When you next use an EKG machine, think for a moment of Einthoven, and the scientists who made this amazing piece of technology possible.

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