Willem Einthoven y su aporte a la Medicina

Willem Einthoven, creador del electrocardiógrafo, nos permitió darle uso clínico al estudio de la actividad eléctrica cardiaca. Las mejoras que introdujo al galvanómetro de cuerda hicieron posible el uso de esta técnica como método diagnóstico universalmente reconocido. Se realiza una reseña biográfica de este científico incluyendo el desarrollo del electrocardiograma y situaciones de interés en relación con este invento.

Who is who in cardiovascular research? What a review of Nobel Prize nominations reveals about scientific trends

Background Since 1901, at least 15 scholars who contributed to cardiovascular research have reveiced a Nobel prize in physiology or medicine. Methods Using the Nobel nomination database (nobelprize.org), which contains 5950 nominations in the accessible period from 1901 to 1953 in physiology or medicine, we listed all international nominees who contributed to cardiovascular research. We subsequently collected nomination letters and jury reports of the prime candidates from the archive of the Nobel Committee in Sweden to identify shortlisted candidates. Results The five most frequently nominated researchers with cardiovascular connections from 1901 to 1953 were, in descending order, the surgeon René Leriche (1879–1955) (FR) with a total of 79 nominations, the physiologist and 1924 Nobel laureate Willem Einthoven (1860–1927) (NL) (31 nominations), the surgeon Alfred Blalock (1899–1964) (US) (29 nominations), the pharmacologist and 1936 Nobel laureate Otto Loewi (1873–1961) (DE, AT, US) (27 nominations) and the paediatric cardiologist Helen Taussig (1898–1986) (US) (24 nominations). The research of these scholars merely hints at the width of topics brought up by nominators ranging from the physiological and pathological basics to the diagnosis and (surgical) interventions of diseases such as heart malformation or hypertension. Conclusion We argue that an analysis of Nobel Prize nominations can reconstruct important scientific trends within cardiovascular research during the first half of the twentieth century.

Electrify your class with a simple battery: battery demonstration of electrocardiogram vectors

William Arthur Ward stated, “The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires.” Discovery experimentation is an inductive method that demonstrates and inspires by creating an interest in determining the underlining basis of a phenomenon. This experiential approach also fosters motivation and enhances learning. Starting with what the student knows augments this approach. By starting with what the student already knows, the student can consciously and explicitly link the subsequent new information with previous knowledge. Accordingly, we used a simple battery as an analogy for electrocardiogram vectors to introduce the theoretical physics of how the heart produces voltages that are detectable at the body surface. This extraordinarily complex physics was approached in a straightforward and inexpensive way while still providing an understanding of the fundamental concepts developed by Willem Einthoven in 1895.

Die Entdeckung des AV-Knotens des Herzens durch Sunao Tawara und Ludwig Aschoff

Already in 1664, the Danish anatomist and naturalist Niels Stensen proved that the heart is a muscle. But for a long time it remained unclear what triggered the heart contractions.The Dutch physiologist Willem Einthoven registered the electrical processes in the contraction of the heart muscle and thus provided the first electrophysiological basis of cardiac muscle activity. Since 1903, Sunao Tawara was assistant to Ludwig Aschoff in Marburg. Both left Marburg in 1906: Tawara went back to Japan and Aschoff to Freiburg. In 1905, Tawara discovered the connections of the His’ bundle to the AV node and the Purkinje fibers. At that time, there was no thought of a functional interpretation. Tawara discovered a kind of “knot” that linked to the adjacent myocardial cells, as well as the “Tawara thighs”, which frayed and went into structures known as Purkinje fibers. Tawara detected the tree-like structure he had discovered as a muscle-fiber system that controlled the arousal of the heart’s musculature. Thus the old dispute between myogenic and neurogenic arousal of the heart was decided in favor of the myogenic excitation conduction. The atrioventricular node described by Tawara was given the eponym “Aschoff-Tawara node”. Tawara’s groundbreaking work on the conduction system was the basis for the discovery of the sinus node and the interpretation of the heart’s electrophysiology.

34. A brief history of cardiac arrhythmia

Throughout the ages there has been little else as impressive to both the patient and physician as abnormalities and aberrancy in the heartbeat. It was through careful observation and characterization of physiology that the tactile measurement of the pulse translated and evolved in to the vast field of cardiology we know today. For thousands of years the only window physicians had into the hearts of their patients was through palpation of a pulse. The ancient Egyptians, Chinese and Greeks are credited with measurement and characterization of peripheral pulses and their association with illness. The work of Claudius Galen (129-199) furthered the association of pulse to cardiac function. Galen’s work set the stage for William Harvey’s (1578-1657) first description of the circulatory system and thereafter the function of the heart. However, it was not until the advent of electrocardiography that modern, efficient studies of cardiac rhythm began. The work of August Desir Waller (1856-1922) and Willem Einthoven (1860-1927) revolutionized the study of arrhythmia with the advent of the electrocardiogram (ECG). This instrument transformed the diagnosis of heart disease and catalyzed the creation of cardiology as a subspecialty. It was through the use of the ECG that cardiac rhythm disorders were first characterized. James Mackenzie and Arthur Cushny first recognized atrial fibrillation and the work of Drs. Wolf, Parkinson and White theorized the neuro-cardiac function of the heart. Further study led to the discovery of the Purkinje system and the mechanics of cardiac electrical conduction. Medicine has thus used many approaches in the treatment of arrhythmias, employing pharmacology, electricity and surgery, with an ever-evolving spectrum of treatment. It was through observation, innovation and determination that diseases of the heart are understood and treated today. Hanon S, Shapiro M, Schweitzer P. A troubled beginning: Evolving concepts of an old arrhythmia. J. Electrocardiol. 2005 (July); 38(3):213-7. Fye,W. Tracing atrial fibrillation - 100 years. N Engl J Med. 2006 (Oct); 5;355(14):1412-4. Lüderitz B. History of the disorders of cardiac rhythm. 3rd Ed. Armonk, NY: Futura Pub. Co., 2002.