Evolution of the ECG Machine

Evolution of the ECG Machine



An electrocardiogram or “ECG machine” is a device that helps physicians understand and interpret the electrical signals that are produced by the heart as it contracts. By doing so, they can diagnose potential heart issues.


Over the past few decades, there have been great advances in the field of medicine. One such area is cardiac care, where modern technologies have led to a better understanding and treatment of heart conditions. When it comes to heart health, the evolution of ECG machines has played a critical role for both doctors and patients alike.


The below article explores the ECG machine, its evolution, and what impact it had on cardiac care.


“ECG machines are now a staple in every hospital and medical clinic and is one of the most common tests requested by cardiologists for their patients.


1887-1930: The Early Days of ECGs 


The first ECGs were rudimentary at best, but they laid the groundwork for the more advanced machines we have today. It was not until 1903 that Willem Einthoven, a Dutch physiologist invented the string galvanometer, which improved the accuracy of ECGs by measuring small electrical currents. This innovation earned Einthoven the Nobel Prize in Physiology or Medicine in 1924.

By the 1930’s, ECGs were being used routinely in hospitals to diagnose heart conditions like arrhythmias and myocardial infarctions (heart attacks). However, these early machines were large and bulky, making them difficult to transport from one location to another. Additionally, they required trained technicians to operate them, which limited their use outside of hospitals.


1930’s-1960’s: The Advent of Portable ECGs 


In 1939, engineer Norman Jolliffe unveiled the first portable ECG machine, which weighed just 35 pounds (16 kg). This machine allowed doctors to more easily transport ECGs from one location to another and even administer them outside traditional hospital settings.

Other advances during this time included the development of self-adhesive electrodes and disposable paper ones, which made recording an ECG quicker and easier than ever before. By the 1960’s, beat-to-beat reporting became possible thanks to new technological advances, furthering the use of ECGs in identifying heart conditions. To make ECG machines more accessible and affordable, several modifications were made over the years. One of the most important modifications was the development of solid-state electronics in the 1950’s.

This replaced the need for string galvanometers with much smaller transistors—which made ECG machines smaller, lighter, and less expensive. The 1950’s saw the development of portable ECGs which allowed patients to be mobile while still monitoring their heart activity. In 1957, John Winters started marketing his own design of an ambulatory ECG called the “Dynamo Cardio scope.”

This machine increased the mobility of patients as well as allowed longer periods of monitoring. However, these ambulatory ECGs were large, bulky, and not very user-friendly, which made them impractical for widespread use. In 1975 World Heal Corporation released their own version called the “Mini Mitter” or “Holter Monitor,” which was much smaller and lighter weight. The Holter monitor became the industry standard for ambulatory ECGs and is still used today in many hospitals around the world.


1970’s-Present: Modern Developments in ECG Technology


The 1970’s saw several important developments in ECG technology, including the introduction of digital readouts and computerized analysis. These advances made it possible for non-specialists to operate ECG machines and led to increased accuracy in diagnosis.

ECG machines continued to evolve throughout the second half of the 20th century. In recent years, digital technology has been used to create compact, handheld devices that can be easily transported from one location to another. Some modern ECG machines can be wirelessly connected to smartphones and other devices so that patients can receive real-time monitoring. Eventually, technology continued to miniaturize further until we arrived at wearable devices such as smartwatches that are now capable of performing Single Lead ECG.

Some of the latest innovations in ECG technology include ultra-portable ECG devices that measure the equivalent of a 12 Lead ECG, without leads, just by touch with the help of artificial intelligence (AI)-based software that can automatically interpret ECGs with high accuracy.

The evolution of ECG machines has played a crucial role in diagnostic medicine by allowing doctors to better understand and interpret the electrical signals produced by heart contraction. ECG machines have come a long way since they were first invented over 100 years ago. They are now smaller, more portable, and easier to use than ever before. This continuous evolution has made them an invaluable tool for diagnosing cardiac conditions. It is evident that there will be more advancement coming our way. As technology becomes more sophisticated, who knows what else the next 100 years hold!”


The Evolution Of ECG Machines – BW Healthcare (businessworld.in)

Public Access Defibrillation Programs: Improving Outcomes Worldwide using Five Steps

Out of hospital cardiac arrest (OHCA) is one of the most frequent causes of death and leading cause of healthcare expenditures. This has led to significant research to study ways to reduce morbidity and mortality secondary to OHCA. The American Heart Association developed a campaign to improve awareness and outcomes of patients suffering an OHCA.

There were five areas they were looking to improve on what is referred as the chain of survival when it comes to OHCA’s.

  1. Immediate recognition of cardiac arrest and activation of the emergency response system
  2.  Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions
  3. Rapid defibrillation
  4. Effective advanced life support
  5. Integrated post‐cardiac arrest care


In this study, they analysed the survival after ventricular fibrillation cardiac arrest in the Sao Paulo Metropolitan Subway System following the implementation of a targeted PAD (public access defibrillator) program. The program placed automated external defibrillators in railway stations and provided Heartsaver First Aid cardiopulmonary resuscitation (CPR) automated external defibrillator training and refresher courses for security officers. The Sao Paulo railway system carries approximately 4.5 million people which provided an optimum place to begin the roll out of the PAD program. The systems‐dedicated security officers and cameras allow for rapid recognition, CPR, and defibrillation.



Results showed that their data combined with prior studies which targeted PAD programs can be successful throughout the world. Increased advocacy is needed to establish more targeted PAD programs worldwide, along with programs to improve all parts of the chain of survival, in particular, public awareness of cardiac arrest and the need for rapid CPR administration.


Read full article in link below;


Public Access Defibrillation Programs: Improving Outcomes Worldwide – PMC (nih.gov)

Are there disparities in the location of automated external defibrillators in England?


Early defibrillation is an essential element of the chain of survival for out-of-hospital cardiac arrest (OHCA). Public access defibrillation (PAD) programmes aim to place automated external defibrillators (AED) in areas with high OHCA incidence, but there is sometimes a mismatch between AED density and OHCA incidence.

The study aimed to assess if there were any disparities in the characteristics of areas that have an AED and those that do not in England.

The results showed that in England, the AED’s seemed to be more accessible in more affluent areas of the country with a lower residential population density.


Read full study in link below;

Are there disparities in the location of automated external defibrillators in England? – PMC (nih.gov)


Getting R-AEDI to save lives in Singapore

Early cardiopulmonary resuscitation (CPR) and defibrillation prior to the arrival of emergency medical services can improve survival from out-of-hospital cardiac arrest (OHCA) with good neurological outcome. However, the rate of local bystander CPR is only 24.3% and bystander defibrillation 2.1%.

In 2015, the R-AEDI (Registry for AED Integration) initiative was started to improve OHCA survival rates. R-AEDI alerts volunteers to nearby OHCA cases via the myResponder mobile application. In 2015-2017, 7,682 AEDs were mapped and made accessible via this app. Comprehensive site inspections also resulted in fewer non-functional AEDs, as AED owners were educated on the importance of the maintenance of pads and batteries. The AED heat map allows us to identify areas that are lacking in or require improved public access AED coverage.

The online AED registry found in the myResponder app is useful to locate AEDs rapidly during OHCAs. More community education would improve the rate of bystander defibrillation.

Getting R-AEDI to save lives in Singapore – PMC (nih.gov)



Network of Automated External Defibrillators in Poland before the SARS-CoV-2 Pandemic: An In-Depth Analysis

Introduction: Sudden cardiac arrest (SCA), which causes more than half of all cardiovascular related deaths, can be regarded as a common massive global public health problem. Analyzing out-of-hospital cardiac arrest (OHCA) cases, one of the key components is automatic external defibrillators (AEDs). Aim: The aim of this study was to analyze the use and distribution of AEDs in Polish public places.

Materials and methods: The data were analyzed by using the Excel and R calculation programs. Results: The data represents 120 uses of automatic external defibrillators used in Polish public space in the period 2008–2018. The analysis describes 1165 locations of AEDs in Poland. It was noted that the number of uses in the period 2010–2016 fluctuated at a constant value, with a significant rise in 2017. When analyzing the time of interventions in detail the following was noted: the highest percentage of interventions was observed in April, and the lowest in November; the highest number of interventions was observed on a Friday, while the least number of interventions was observed on a Sunday; most occurred between 12:00 to 16:00, and least between 20:00 to 8:00.

Conclusions: The observed growth in the number of cases of AED use in public places is associated with the approach to training, the emphasis on public access to defibrillation, and, therefore, the growth of social awareness.

This study will be continued. The next analysis would include 2020–2022 and would be a comparative analysis with the current research.


Location of out-of-hospital cardiac arrests and automated external defibrillators in relation to schools in an English ambulance service region

Introduction: This study sought to identify the availability of automated external defibrillators (AEDs) in schools in the region served by West Midlands Ambulance Service University NHS Trust (WMAS), United Kingdom, and the number of out-of-hospital cardiac arrests (OHCA) that occurred at or near to schools. A secondary aim was to explore the cost effectiveness of school-based defibrillators.

Methods: This observational study used data from the national registry for OHCA (University of Warwick) to identify cases occurring at or near schools between January 2014 and December 2016 in WMAS region (n = 11,399). A school survey (n = 2,453) was carried out in September 2017 to determine the presence of AEDs and their registration status with WMAS. Geographical Information System mapping software identified OHCAs occurring within a 300-metre radius of a school. An economic analysis calculated the cost effectiveness of school-based AEDs.

Results: A total of 39 (0.34%) of all OHCAs occurred in schools, although 4,250 (37.3%) of OHCAs in the region were estimated to have occurred within 300 metres of a school. Of 323 school survey responses, 184 (57%) had an AED present, of which 24 (13.0%) were available 24 h/day. Economic modelling of a school-based AED programme showed additional quality-adjusted life years (QALY) of 0.26 over the lifetime of cardiac arrest survivors compared with no AED programme. The incremental cost-effectiveness ratio (ICER) was £8,916 per QALY gained.


ConclusionCardiac arrests in schools are rare. Registering AEDs with local Emergency Medical Services and improving their accessibility within their local community would increase their utility.


Defibrillators added to FDA’s list of device shortages

The Food and Drug Administration added automated external defibrillators (AED) to its list of medical devices in short supply. The AED supply disruption reflects both surging demand and problems sourcing a component, part or accessory. For wearable and non-wearable AEDs, the supply disruption is expected to last for the duration of 2022, the FDA said. In a footnote, the FDA added there is a global shortage of semiconductor chips that are essential to some medical devices. The regulator linked to the footnote in its description of the problems with a component, part or accessory that are affecting AEDs. Six entries — two AEDs and four ventilators — are linked to the chip shortage.


Facility-Level Factors and Racial Disparities in Cardiopulmonary Resuscitation within US Dialysis Clinics

  • Clinics caring for Black versus White cardiac arrest patients have significant differences in quality, resources, and patient case mix.
  • Accounting for differences in clinic characteristics between Black versus White cardiac arrest patients did not reduce race disparities in cardiopulmonary resuscitation.
  • Relative to younger patients, older Black patients were less likely to receive cardiopulmonary resuscitation (including AED use) in dialysis clinics compared with older White patients.


The Impact of Medical Students Teaching Basic Life Support to Laypersons

Basic life support (BLS) courses for laypersons, including cardiopulmonary resuscitation (CPR) training, is known to improve outcomes of out-of-hospital cardiac eventsWe asked medical students to provide BLS training for laypersons as a part of their emergency medicine education and evaluated the effects of training on the BLS skills of laypersons. We also used a questionnaire to determine whether the medical students who provided the BLS training were themselves more confident and motivated to perform BLS compared to students who did not provide BLS training. The proportions of laypersons who reported confidence in checking for a response, performing chest compressions, and automated external defibrillator (AED) use were significantly increased after the BLS training. The proportions of medical students who reported increased confidence/motivation in terms of understanding BLS, checking for a response, chest compression, use of AED, and willingness to perform BLS were significantly greater among medical students who provided BLS instructions compared to those who did not. BLS instruction by medical students was associated with an improvement in laypersons’ CPR accuracy and confidence in responding to cardiac arrest. The results indicate that medical students could gain understanding, confidence, and motivation in regard to their BLS skills by teaching BLS to laypersons.