Jtubilee Editorial Electrocardiography then and now : where next ?

When the Cardiac Society of Great Britain and Ireland met for the first time its initial task was to set up a committee to define the best location for a single chest electrocardiograph lead. The recommendations were agreed with the American Heart Association and a joint report was published in both countries and republished in the first issue of the British Heart Journal.' At that time the electrocardiograph was the specialised investigation in cardiology; indeed it was the first clinical tool to become an essential component of cardiac practice since the introduction of the stethoscope, ophthalmoscope, and sphygmomanometer. An indication of its importance is its predominance in the first volume of the British Heart Journal, published in 1939. Of the 23 original articles that appeared that year, the electrocardiograph was the topic, or an important feature, in 12. Its importance remains undiminished. As Fisch has reminded us2: it is a non-invasive technique that does not harm the patient; it is inexpensive, simple, and reproducible; it permits serial studies to be made; and provides the only practical means of recording the cardiac action potential. It has several other virtues: it provides an independent marker of myocardial infarction, and enables one to undertake complex electrophysiological analysis through deductive reasoning. Fifty years before the transformation of the Cardiac Club into the British Cardiac Society, Augustus Desire Waller recorded the first electrocardiogram in man, using a Lippmann capillary electrometer.3 Though this technique was impracticable for clinical use, this observation led to the introduction by Einthoven of his string galvanometer as a clinical instrument.4 This aspect is more fully discussed by Howard Burchell on page 190 of this issue. Once Einthoven had established the basis, he selected the