Skip to main content
SpringerLink
Log in

The Electrocardiogram and Its Relationship to Excitation of the Heart

  • Chapter
Physiology and Pathophysiology of the Heart

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 90))

  • 314 Accesses

Abstract

If voltage is recorded as a function of time between two electrodes separated on the body surface, a sufficiently sensitive amplifier will show that a changing voltage exists between the two electrodes that has the same periodicity as the heart beat. A.D. Waller {l} and others demonstrated around 1900 that this voltage originates in the electrical activity of the heart. Accurate measurement of such electrocardiograms (ECGs) was greatly facilitated by the invention of the string galvanometer by Einhoven {2}. The string galvanometer, although bulky, was the first recording instrument capable of producing electrocardiograms comparable in fidelity to those observed today.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Waller AD: On the electromotive changes connected with the beat of the mammalian heart and of the human heart in particular. Phil Trans Roy Soc B 180: 169–94, 1889.

    Article  Google Scholar 

  2. Einthoven W, Fahr G, De Waart A: Uber die rich-tung und manifeste grosse der potentialschwankungen im menschlichen herzen und über den einfluss der herzlage auf die form des elektrocardiograms. Pflügers Arch ges 150: 275-315, 1913. Translated: Am Heart J 40: 163–211.

    Google Scholar 

  3. Lewis T, Rothschild MA: The excitatory process in dog’s heart. Part II. The ventricles. Phil Trans Roy Soc B 206: 181–226, 1915.

    Article  Google Scholar 

  4. Goldman MJ: Principles of Clinical Electrocardiography, 10th edition. Los Altos, California: Lange Medical Publications, 19.

    Google Scholar 

  5. Flowers NC, Shvartsman V, Kennelly BM, Sohi GS, Horan LG: Surface recording of His-Purkinje activity on an every-beat basis without digital averaging. Circulation 63: 948–952, 1981.

    Article  PubMed  CAS  Google Scholar 

  6. Association for the Advancement of Medical Instrumentation: Standard for Diagnostic ECG Devices. ByVirginia: AAMI.

    Google Scholar 

  7. Spach MS, Barr RC, Havstad JW, Long EC: Skin electrode impedance and its effect on recording cardiac potentials. Circulation 34: 649–656, 1966.

    PubMed  CAS  Google Scholar 

  8. Schmitt OH, Almasi JJ: Electrode impedance and voltage offset as they affect efficacy and accuracy of VCG and ECG measurement. In: Proceedings of the XIth International Vectorcardiography Symposium. North-Holland Publishing Co, 1970.

    Google Scholar 

  9. Huhta JC, Webster JG: 60-Hz Interference in Electrocardiography. IEEE Transactions on Biomedical Engineering, BME-20: 91–101, 1973.

    Article  Google Scholar 

  10. American Heart Association Committee on Electrocardiography: Electrical Safety Standards for Electrocardiographic Apparatus. (DB Geselowitz, Chairman), Circulation 61: 669, 1980.

    Google Scholar 

  11. Wilson FN, Macleod AG, Barker PS: The order of ventricular excitation in bundle branch block. Amer Heart J 7: 305–330, 1932.

    Article  Google Scholar 

  12. Goldberger E: Unipolar Lead Electrocardiography and vectorcardiography. Philodelphia: Lea and Febiger, 1953.

    Google Scholar 

  13. Frank E: An accurate clinically practical system for spatial vectorcardiography. Circulation 13: 737–749, 1956.

    PubMed  CAS  Google Scholar 

  14. Barr RC, Spach MS, Herman-Giddens GS: Selection of the number and positions of measuring locations for electrocardiography. IEEE Trans Biomed BME-18: 125–38, 1971.

    Article  Google Scholar 

  15. Lux RL, Smith CR, Wyatt RF, Abildskov JA: A limited lead selection for estimation of body surface potential maps in electrocardiography. IEEE Trans Biomed BME-25: 270–276, 1978.

    Article  Google Scholar 

  16. Goldberger AL, Bhargava V, Froelicher V, Covell J: Effect of myocardial infarction on high-frequency QRS potentials. Circulation 64: 34–42, 1981.

    Article  PubMed  CAS  Google Scholar 

  17. Barr RC, Spach MS: Sampling rates required for digital recording of intracellular and extracellular cardiac potentials. Circ Res 55: 40–48, 1977.

    CAS  Google Scholar 

  18. Ruttimann UE, Pipberger HV: Compression of the ECG by prediction or interpolatin and entropy encoding. IEEE Trans BME BME-26: 613–623, 1979.

    Google Scholar 

  19. DiPersio DA, Barr RC: Evaluation of the fan method of adaptive sampling on human electrocardiograms. Med & Biol Engng & Comput 23: 401–410, 1985.

    Article  CAS  Google Scholar 

  20. McFee R, Baule GM: Research in electrocardiography and magnetocardiography. Proc. IEEE 60: 290–322, 1972.

    Article  Google Scholar 

  21. DeMello WC: Intracellular communication in cardiac muscle. Circ Res 51: 1–9, 1982.

    CAS  Google Scholar 

  22. Eycleshymer AC, Schoemaker DM: A Cross-section Anatomy. New York: Appleton-Century-Crofts, Inc, 1911.

    Google Scholar 

  23. Spach MS, Barr RC, Johnson EA, Kootsey JM: Cardiac extracellular potentials: Analysis of complex wave forms about the Purkinje network in dogs. Circ Res 33: 465–473, 1973.

    PubMed  CAS  Google Scholar 

  24. Burger HC and Van Milaan JB: Heart vector and leads. Parts I, II and III. Br Heart J, 8: 157, 1946; 9: 154,1947; 10: 229, 1948.

    Google Scholar 

  25. Scher A, Young A: The pathway of ventricular depolarization in the dog. Circ Res 4: 461–469, 1956.

    PubMed  CAS  Google Scholar 

  26. Durrer D, van Dam R, Freud MG, Janse MJ, Meijler FL, Arzbaecher RC: Total excitation of the heart. Circulation 41: 899–912, 1970.

    PubMed  CAS  Google Scholar 

  27. Spach MS, Barr RC, Lanning CF, Tucek PC: Origin of body surface QRS and T wave potentials from epicardial potential distributions in the intact chimpanzee. Circulation 55: 268–278, 1977.

    PubMed  CAS  Google Scholar 

  28. Ramsey III M, Barr RC, Spach MS: Comparison of measured torso potentials with those simulated from epicardial potentials for venctricular depolarization and repolarization in the intact dog. Circ Res 41: 660–672, 1977.

    PubMed  Google Scholar 

  29. Rudy Y, Plonsey R: A comparison of volume conductor and source geometry effects on body surface and epicardial potentials. Circ Res 46: 283–291, 1980.

    PubMed  CAS  Google Scholar 

  30. Gulrajani RM, Mailloux GE: A simulation study of the effects of torso inhomogeneities on electrocardiographic potentials using realistic heart and torso models. Circ Res 52: 45–56, 1983.

    PubMed  CAS  Google Scholar 

  31. Okajima M, Fujino T, Kobayashi T, Yamada K: Computer simulation of the ventricles of the heart. Circ Res 23: 203–210, 1968.

    PubMed  CAS  Google Scholar 

  32. Miller III WT, Geselowitz DB: Simulation studies of the electrocardiogram II. Ischemia and infarction. Circ Res 43: 315–23, 1978.

    PubMed  Google Scholar 

  33. Meiler FL: In: A New Coding System for Electrocardiography. Amsterdam: Excerpta Medica, EO Robles de Medina, 1972.

    Google Scholar 

  34. Plonsey R: Bioelectric Phenomena. New York: McGraw-Hill, 1969, pp 202–275.

    Google Scholar 

  35. Hurst JW, Logue RB, Schlant, Wenger NK: The Heart, 4th ed. New York: McGraw-Hill, 1978, p 309.

    Google Scholar 

  36. Holter NJ: New methods for heart studies: Continuous electrocardiography of active subjects. Science 134: 1214–1220, 1961.

    Article  PubMed  CAS  Google Scholar 

  37. Webster JG: An intelligent monitor for ambulatory ECGs. Biomed Sei Instrum 14: 55–60, 1978.

    CAS  Google Scholar 

  38. Mirowski M, Reid PR, Mower MM, Watkins L, Gott VL, Schäuble JF, Langer A, Heilman MS, Kolenik SA, Fischell RE, Weisfeldt ML: Termination of malignant ventricular arrhythmias with an implantable automatic defibrillator in human beings. N Eng J Med 303: 322–324, 1980.

    Article  CAS  Google Scholar 

  39. Thakor NV: From Holter monitors to automatic defibrillators: Developments in ambulatory arrhythmia monitoring. IEEE Trans Biomed Eng BME-31: 770–778, 1984.

    Article  Google Scholar 

  40. Pipberger HV, Schneiderman MA, Klingeman JD: The love-at-first-sight effect in research. Circulation 38: 822–825, 1968.

    PubMed  CAS  Google Scholar 

  41. Gabor D, Nelson CV: Determination of the resultant dipole of the heart from measurements on the body surface. J Appl Phys 25: 413–16, 1954.

    Article  Google Scholar 

  42. Geselowitz DB: Two theorems concerning the quad rupole applicable to electrocardiography. IEEE Trans Biomed Eng BME-12: 164–168, 1965.

    Article  Google Scholar 

  43. Ideker RE, Bandura JP, Larsen RA, Cox JW, Keller FW, Brody DA: Localization of heart vectors produced by epicardial burns and ectopic stimuli. Circ Res 36: 105–112, 1975.

    PubMed  CAS  Google Scholar 

  44. Savard P, Roberge FA, Perry JB, Nadeau RA: Representation of cardiac electrical activity by a moving dipole for normal and ectopic beats in the intact dog. Circ Res 46: 415–425, 1980.

    PubMed  CAS  Google Scholar 

  45. Taccardi B: Distribution of heart potentials on the thoracic surface of normal human subjects. Circ Res 12: 341–352, 1963.

    PubMed  CAS  Google Scholar 

  46. Rush S, Lepeschkin: Body surface mapping of cardiac fields. Advances in Cardiology, Vol 10. New York: S. Karger, 1974.

    Google Scholar 

  47. Yajima K, Kinoshita S, Tanaka H, Ihara T, Furukawa T: Body surface potential mapping system equipped with a microprocessor for the dynamic observation of potential patterns. Med & Biol Eng & Comput 21: 83–90, 1983.

    Article  CAS  Google Scholar 

  48. Holt, J, Barnard ACL, Lynn M: The study of the human heart as a multiple dipole source II. Diagnosis and quantization of left ventricular hypertrophy. Circ Res 40: 697–710, 1969.

    Google Scholar 

  49. Barr RC, Spach MS: Inverse calculations of QRS-T epicardial potentials from body surface potential distributions for normal and ectopic beats in the intact dog. Circ Res 42: 661–75, 1978.

    PubMed  CAS  Google Scholar 

  50. Wilson OB, Macleod AG, Barker PS: The T-deflection of the electrocardiogram. Trans Assoc Am Phys 46: 29–38, 1931.

    Google Scholar 

  51. AbildskovJA, Burgess MJ, Millar K, Wyatt R, Baule G: The primary T wave. A new electrocardiographic waveform. Am Hear J 81: 242–249, 1971.

    Article  Google Scholar 

  52. Horan LG, Hand RC, Johnson JC, Sridharan MR, Rankin TB, Flowers NC: A theoretical examination of ventricular repolarization and the secondary T wave. Circ Res 42: 750–757, 1982.

    Google Scholar 

  53. Geselowitz DB: Use of time integrals of the ECG to solve the inverse problem. IEEE Trans BME BME-32: 73–75, 1985.

    Article  Google Scholar 

  54. Nikias CL, Raghuveer MR, Siegel JH, Fabian M: The zero-delay wavenumber spectrum estimation for the analysis of array ECG signals. IEEE Trans BME BME-33: 435–452, 1986.

    Article  Google Scholar 

  55. Barr RC: Finding the site of origin and velocity of propagation in a short one-dimensional strand from two extracellular waveforms. IEEE Trans BME BME-31: 546–550, 1984.

    Article  Google Scholar 

Download references

Authors
  1. Roger C. Barr
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Physiology and Biophysics and College of Medicine, University of Cincinnati, 231 Bethesda Avenue, 45267-0579, Cincinnati, OH, USA

    Nicholas Sperelakis

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Kluwer Academic Publishers

About this chapter

Cite this chapter

Barr, R.C. (1989). The Electrocardiogram and Its Relationship to Excitation of the Heart. In: Sperelakis, N. (eds) Physiology and Pathophysiology of the Heart. Developments in Cardiovascular Medicine, vol 90. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0873-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-0873-7_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8222-8

  • Online ISBN: 978-1-4613-0873-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation