Ventricular fibrillation historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Lyman Brewer suggests that the first recorded incident of ventricular fibrillation dates as far back as 1500 BC, and can be found in the Ebers papyrus of ancient Egypt. A book authored by Jo Miles suggests that it may even go back farther. Tests done on frozen remains found in the Himalayas seemed fairly conclusive that the first known case of ventricular fibrillation dates back to at least 2500 BC. Whether this is a description of ventricular fibrillation is debatable. The next recorded description occurs 3000 years later and is recorded by Vesalius, who described the appearance of "worm-like" movements of the heart in animals prior to death. In 1842, Dr. John Erichsen described ventricular fibrillation following the ligation of a coronary artery (Erichsen JE 1842). In 1850, fibrillation was described by Ludwig and Hoffa when they demonstrated the provocation of ventricular fibrillation in an animal by applying a "Faradic" (electrical) current to the heart. In 1874, Edmé Félix Alfred Vulpian coined the term mouvement fibrillaire, a term that he seems to have used to describe both atrial and ventricular fibrillation. In 1887, Dr. John A. MacWilliam, a physiologist, gave an accurate description of the arrhythmia. Dr. MacWilliam was one of the first to show that ventricular fibrillation could be terminated by a series of induction shocks through the heart. In 1912, the first electrocardiogram recording of ventricular fibrillation was by Dr. August Hoffman. In 1922, Dr. Kerr and Dr. Bender produced an electrocardiogram showing ventricular tachycardia evolving into ventricular fibrillation. The re-entry mechanism was also advocated by DeBoer, who showed that ventricular fibrillation could be induced in late systole with a single shock to a frog heart. In 1928, The concept of "R on T ectopics" was further brought out by Dr. Katz. This was called the “vulnerable period” by Wiggers and Wegria in 1940, who brought to attention the concept of the danger of premature ventricular beats occurring on a T wave. In 1940, another definition of VF was produced by Dr. Wiggers. He described ventricular fibrillation as "an incoordinate type of contraction which, despite a high metabolic rate of the myocardium, produces no useful beats. As a result, the arterial pressure falls abruptly to very low levels, and death results within six to eight minutes from anemia of the brain and spinal cord".

Historical Perspective

  • Lyman Brewer suggests that the first recorded incident of ventricular fibrillation dates as far back as 1500 BC, and can be found in the Ebers papyrus of ancient Egypt.
  • A book authored by Jo Miles suggests that it may even go back farther. Tests done on frozen remains found in the Himalayas seemed fairly conclusive that the first known case of ventricular fibrillation dates back to at least 2500 BC.[1] Whether this is a description of ventricular fibrillation is debatable.[2]
  • The next recorded description occurs 3000 years later and is recorded by Vesalius, who described the appearance of "worm-like" movements of the heart in animals prior to death.
  • In 1842, Dr. John Erichsen described ventricular fibrillation following the ligation of a coronary artery (Erichsen JE 1842).
  • In 1850, fibrillation was described by Ludwig and Hoffa when they demonstrated the provocation of ventricular fibrillation in an animal by applying a "Faradic" (electrical) current to the heart.
  • In 1874, Edmé Félix Alfred Vulpian coined the term mouvement fibrillaire, a term that he seems to have used to describe both atrial and ventricular fibrillation.
  • In 1887, Dr. John A. MacWilliam, a physiologist, gave an accurate description of the arrhythmia. This definition still holds today and is interesting in the fact that his studies and description predate the use of electrocardiography. His description is as follows: "The ventricular muscle is thrown into a state of irregular arrhythmic contraction, whilst there is a great fall in the arterial blood pressure, the ventricles become dilated with blood as the rapid quivering movement of their walls is insufficient to expel their contents; the muscular action partakes of the nature of a rapid incoordinate twitching of the muscular tissue. The cardiac pump is thrown out of gear, and the last of its vital energy is dissipated in the violent and the prolonged turmoil of fruitless activity in the ventricular walls."
  • Dr. MacWilliam was one of the first to show that ventricular fibrillation could be terminated by a series of induction shocks through the heart.
  • In 1912, the first electrocardiogram recording of ventricular fibrillation was by Dr. August Hoffman.
  • Simultaneously, two other researchers, Mines and Garrey, working separately, produced work demonstrating the phenomenon of circus movement and re-entry as possible substrates for the generation of arrhythmias. This work was also accompanied by Lewis, who performed further outstanding work into the concept of "circus movement".
  • In 1922, Dr. Kerr and Dr. Bender produced an electrocardiogram showing ventricular tachycardia evolving into ventricular fibrillation.
  • The re-entry mechanism was also advocated by DeBoer, who showed that ventricular fibrillation could be induced in late systole with a single shock to a frog heart.
  • In 1928, The concept of "R on T ectopics" was further brought out by Dr. Katz.
  • This was called the “vulnerable period” by Wiggers and Wegria in 1940, who brought to attention the concept of the danger of premature ventricular beats occurring on a T wave.
  • In 1940, another definition of VF was produced by Dr. Wiggers. He described ventricular fibrillation as "an incoordinate type of contraction which, despite a high metabolic rate of the myocardium, produces no useful beats. As a result, the arterial pressure falls abruptly to very low levels, and death results within six to eight minutes from anemia of the brain and spinal cord".

References

  1. Brewer LA (1983). "Sphygmology through the centuries. Historical notes". Am. J. Surg. 145 (6): 695–701. doi:10.1016/0002-9610(83)90124-1. PMID 6344674.
  2. Brewer LA (1983). "Sphygmology through the centuries. Historical notes". Am. J. Surg. 145 (6): 696–702. doi:10.1016/0002-9610(83)90124-1. PMID 6344674.

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