{'fraction_non_alphanumeric': 0.02481012658227848, 'fraction_numerical': 0.010126582278481013, 'mean_word_length': 5.061349693251533, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The Electrocardiogram 102 Years After Einthoven

In 2002, we celebrated in the Netherlands the 100th anniversary of Einthoven’s first publication on the electrocardiogram (ECG).1,2 During the past century, the ECG has become indispensable for rapid diagnosis and management of patients with a wide variety of cardiac diseases. As pointed out by Fisch,3 the ECG is an easily available, patient-friendly, noninvasive, inexpensive, and reproducible technique, without peer for the diagnosis of myocardial ischemia, cardiac arrhythmias, structural changes of the myocardium, drug effects, and electrolyte and metabolic disturbances.

Twenty years ago, we reviewed the advances in electrocardiology at that time.4 Now, we would like to discuss new information that can be obtained from the “simple” 12-lead ECG. The limited number of words allowed in an editorial makes it impossible to discuss the ionic and cellular basis of the normal and abnormal ECG and to look at recent studies that used more sophisticated and complex noninvasive techniques to obtain information about the electrical activity of the heart. We will focus on 4 areas in which new information that is useful in our daily cardiology practice has become available.

In recent years, rapid decision-making has become mandatory in patients presenting with symptoms of acute cardiac ischemia. In that situation, information about the size of the area at risk and the severity of ischemia is essential. The ECG can (and should) play an important role in selecting the need for and type of coronary reperfusion procedure.

Traditionally, in ST-segment–elevation myocardial infarction, the size of the area at risk can be estimated from the ST-segment deviation score.5 Counting the number of millimeters that the ST segment deviates (elevated or depressed) from the isoelectric line in the 12-lead ECG is an easy method to obtain information about the size of the area at risk. The higher the ST-segment deviation …