History of Basic Science in Cardiac Electrophysiology

Abstract

Basic cardiac electrophysiology (EP) has been inspired by 2 disciplines, clinical cardiology and membrane/cellular biophysics. Early in the twentieth century, the field was clinically oriented, seeking to understand the relation between disease and cardiac electrograms. Other scientists, motivated by a desire to understand natural systems, were studying the general origin of cellular electric properties. Although communication between the 2 areas has sometimes been suboptimal, theymerged to form our modern basic cardiac EP. Modern electronics and digital computers have also been critical to both basic and clinical EPs, providing essential tools for both basic insights and clinical applications of cardiac EP. The field has flourished with good ideas. Understanding the origin of ideas is fraught with difficulty. Ideas typically derive from interaction, combined with contemplation and study. However, scientific creative processes are rarely explained in a form accessible to a historian. The scientific literature has developed a publishing format that is focused on how to reproduce the reported results, not on how the ideas were developed. Hodgkin describes the problem thus: scientists tend to publish how the experiments should have been conceived and performed rather than how the investigators actually stumbled on their answers. Consequently, the important creative process is often obscured in the otherwise voluminous scientific literature.