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How Echocardiography Entered the Digital Age (Part 2) - Written by Dr. Harvey Feigenbaum

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  • How Echocardiography Entered the Digital Age (Part 2) - Written by Dr. Harvey Feigenbaum

    Early Digital Echocardiography

    I saw the 10-second SONY frame grabber around 1982. Soon thereafter a longer frame grabber was developed. By 1984 we were able to digitally record and display an 8-frame cardiac cycle of a quad view image consisting of the parasternal long axis and short axis at the papillary muscle and apical 4 chamber and 2 chamber views. We were essentially recording a 350 millisecond cardiac cycle. To make it resemble a real cardiac cycle, we grabbed the frames at 50 ms intervals and played them back at 100 ms intervals. Thus we were actually only recording systole, and “diastole” was a 100 ms blank. We stored the digital images on floppy disks. The digital recordings functioned as an “abstract” of the full study which was still recorded on videotape. The quad view digital recording was very useful for making off-line measurements which could be checked and changed by reading physicians. It was useful making side-by-side comparisons of serial studies and was very useful to show to referring physicians.

    In 1991 we developed our first digital file server, and we no longer needed to record on floppy disks, which numbered in the thousands by that time. Shortly thereafter, the digital world exploded and advances in technology were almost every day. So I went on the road promoting digital echocardiography. Our system was home grown. Ultrasound companies also recognized the digital revolution and began developing their own proprietary digital systems. When I saw their efforts, I immediately became suspicious. A digital system controls the laboratory. A proprietary digital system is designed to work with the company’s ultrasound instruments. One never knows what company will have the best up-to-date echo instrument at a given time. For this reason, we have never had a single company laboratory. Thus I strongly felt that the field needed a well-designed, totally generic, digital system.