History of the International Society for Holter Monitoring (ISHM) and the International Society for Holter and Noninvasive Electrocardiology (ISHNE): 1979-2015

The history of ISHM and its successor ISHNE began with scientific symposia. In 1979 Antonio Bayes de Luna organized a first international educational symposium on Holter Electrocardiography in Barcelona, which was presented as a professional service by Del Mar Avionics, Irvine, USA. At this symposium Bruce Del Mar started a longstanding partnership with ISHM and ISHNE and their many scientific members up to the present time. In 1983 Vinzenz Hombach, who was not aware of Antonio´s symposium, organized an international meeting on Holter Monitoring in Cologne. He invited Shlomo Stern as one of the international leaders in Holter monitoring and in particular as an expert of silent myocardial ischemia detected by Holter electrocardiography to present a paper on silent ischemia, but Shlomo was unable to come to Cologne. Instead of Shlomo, Dan Tzivoni, his co-worker, presented work on silent myocardial ischemia. In 1985 Vinzenz Hombach organized a second international symposium in Cologne entitled “Invasive Cardiovascular Therapy – Recent Advances and Future Developments”.

Shlomo Stern, who was among the lecturers, discussed with Vinzenz – as a general consideration – to continue with further international symposia on the Holter monitoring technique and its clinical applications. Shlomo invited Vinzenz to come to Jerusalem to prepare the next international symposium in Jerusalem, with Shlomo Stern and Vinzenz Hombach as the chairmen. These very first contacts between Shlomo, a Jew who had suffered from the Nazi terror in his hometown Budapest, and Vinzenz, whose parent’s generation had tolerated or were enthusiastic with all the Nazi activities, were of course strained. But after intense conversations Shlomo was generous enough to find a final point of view by saying: “Vinzenz, we should not forget theses atrocities, but we should look into the future”. Over the years this lead to a deep friendship between Shlomo and Vinzenz. During these activities in Jerusalem, Shlomo proposed to call the 1986 Jerusalem meeting (Fig. 1) the “2nd International Symposium on Holter Monitoring”, and the idea of a regular follow-up of ISHM´s and ISHNE´s biannual congresses was born.

Fig. 1: 2nd International Symposion on Holter Monitoring 1986 in Jerusalem; Harold Kennedy, Shlomo Stern and Vinzenz Hombach
Fig. 2: Founding Members of ISHM 1988 in Vienna: Harold Kennedy, Peter Cohn, Dan Tzivoni, Arthur Moss, Antonio Bayes de Luna, Vinzenz Hombach, sitting: Shlomo Stern and Heinz Weber

At the Jerusalem meeting three other friends and experts in electrocardiology and Holter electrocardiography were present as active participants, Antonio Bayes de Luna, Harold Kennedy, and Arthur Moss. All three clinicians had already participated in the 1983 Cologne symposium on Holter monitoring. And during the Jerusalem event these three colleagues discussed the matter of founding an International Society together with Shlomo Stern and Vinzenz Hombach. At the end all five scientists were convinced to start with a new special international Society to further develop and distribute all aspects of the Holter monitoring technique and its clinical applications worldwide. The plan was to attract as many clinicians and researchers in this field as possible within such an international scientific body.

The next step was taken in Vienna in 1988 during the “3rd International Symposium on Holter Monitoring”, organized by Prof Kaindl and Heinz Weber, when the first Board of Trustees indeed founded the International Society of Holter Monitoring (ISHM). The members of this inaugural procedure are seen in Figure 2. At this meeting, Shlomo Stern was elected President of ISHM. Shlomo Stern´s term as President lasted from 1988 till 1992, and he was followed by Harold Kennedy as the new President (1992-1994), and thereafter by Arthur Moss (1994-1996), the list of the Presidents of ISHM and later on of ISHNE are shown below and on ISHNE´s website. Following the Vienna Symposium, the organisational structure of the new Society, the function of its Officers, and Governors, and the type of membership were discussed by the new Board of Trustees (BOT). Finally Arthur Moss – during his presidency – established the ISHM formally as an international, non-profit organization in Rochester, New York, USA, and he constructed and wrote down the Bylaws of our Society, that were approved by the BOT.

Soon after founding of ISHM, it became clear that this new Society must have its own journal. Shlomo Stern negotiated this matter with Taylor & Francis Ltd, and after intensive discussions the “Journal of Ambulatory Monitoring” (JAM) was launched in 1989 with Shlomo Stern as the Editor-in-Chief. The JAM remained the official journal of ISHM until 1996, when the name of the Society was changed into ISHNE and a new official journal was launched, the “Annals of Nonivasive Electrocardiology” (ANE), with Arthur Moss as Editor-in-Chief and Shlomo Stern as Co-Editor-in-Chief (Figure 3).

Figure 3: First official Journal of ISHM New official Journal of ISHNE

Subsequently, ISHNE congresses were held roughly every two years between 1990 and 2015 involving locations in London, England; St. Louis, USA; Barcelona, Spain; Tokyo, Japan; Istanbul, Turkey; Buenos Aires, Argentina; Gdansk, Poland; Athens, Greece; Yokohama, Japan; Moscow, Russia, Timisoara, Romania; and Lyon, France.

The next important step in the development and visibility of ISHNE was to establish a new website, and this was realized under the leadership of Sergio Dubner. In addition, Sergio together with his colleagues organized several extremely successful Internet-based international symposia (for reports on these achievments see Moss AJ et al. Am J Cardiol 2004; 94: 1588-89 and Dubner S et al. ANE 2007; 12: 1-6).

Another important activity was the organization of special ISHNE educational symposia and meetings, and this was headed by Wojciech Zareba together with his colleagues. These educational activities that substantially amplified the visibility of ISHM and ISHNE were held worldwide at all important international congresses (AHA, ACC, ESC, Cardiostim etc.) and at important national meetings (in USA, Poland, Germany, France, Spain etc.).

After a long period of continuous regular change of Presidents terms of ISHM and ISHNE (Shlomo Stern: 1988-1992, Harold Kennedy: 1992-1994, Arthur Moss: 1994-1996, Vinzenz Hombach: 1996-1998, Branco Mautner: 1998-2000, Prakash Deedwania: 2000-2003, Ali Oto: 2003-2005, Wojciech Zareba: 2005-2007, Sergio Dubner: 2007-2009, Peter Stone: 2009-2012), Ryszard Piotrowicz: 2012-2015), Jonathan Steinberg is the current President of ISHNE from 2015 to 2017.

A scientific Society such as ISHNE not only depends on the activities of its BOT, Officers and Governors, but also significantly on the input of its official members. In the past ISHNE had some problems in raising membership worldwide. Therefore an open web-based type of membership was developed that allows basic or clinical scientists to become members of ISHNE. Recently, a special class of ISHNE Fellows was instituted in order to attract internationally scientists to the objectives of ISHNE.

One major task of a scientific Society is to delegate members to participate in the production of Guidelines and Consensus Documents. ISHNE members created several important Guideline papers including: “Evaluation of drug-related QT prolongation”, “Heart Rate Turbulence”, “T-Wave Alternans”, and, in coproduction with EHRA, “Remote Monitoring of Cardiovascular Implantable Devices”. ISHNE members also participated in further Guideline productions together with other international Societies like the AHA, ACC and the ESC, with the latest work in progress “2016 ISHNE-HRS Expert Consensus Statement on Ambulatory ECG and External Cardiac Monitoring/Telemetry” planned to be published in September 2016 jointly on ANE and Heart Rhythm.

From the early activities of Holter monitoring meetings organized by different members of the BOT of ISHM/ISHNE, Bruce Del Mar was associated with the scientific endeavours and he was the pioneering supporter and sponsor not only of the researchers themselves, but also of the later founded Societies ISHM and ISHNE. After prior negotiations by Shlomo Stern, Harold Kennedy and Arthur Moss, Bruce donated the Del Mar Young Investigator and Senior Investigator Award. The first awards were handed over 1988 to four senior researchers in Holter monitoring at the “3rd International Symposium on Holter Monitoring” in Vienna (Figure 4): Eliot Corday, Lawrence Hinkle, John Gilson, and Herman Hellerstein. A list of Bruce Del Mar awardees is presented on ISHNE´s website.

Figure 4: The first four Del Mar Award recipients at the 3rd International Symposium on Holter Monitoring 1988 in Vienna

The success and prosperity of a scientific Society very much depends on the active contributions of the members and officials, and particularly from the constant succeeding of young scientists and clinicians to take over the responsibility of the Society´s goals and perspectives. In this respect ISHNE has been very successful since the early beginnings. These accomplishments of ISHNE include worldwide education in all types of educational electrocardiologic sessions including web-based symposia and the biannual congresses that have facilitated interdisciplinary research communication and publication of scientific studies.

We all are aware that all the time from the first plans to establish our Society until the last minute in October 2013, we had a driver behind the scene, Professor Shlomo Stern. His official activities included first, giving the signal to create a new Society, together with Antonio, Harold, Arthur and Vinzenz, and serving as the first President of the new Society ISHM, then acting as Editor-in-Chief of its first official Journal (JAM), and later on as Co-Editor-in-Chief of the new Journal (ANE) of ISHNE. He participated in every biannual international Congress of ISHM and ISHNE, and he was also present in nearly all BOT-meetings of our Society around the world. Behind the scene he brought together many leaders in electrocardiology, convincing them to work together and be involved in ISHNE. His oral contributions were always appropriate and welcome. He spoke, as the past President Ryszard Piotrowicz said, “quietly, wisely, and as the last one-summarizing discussions and proposing innovative solutions”. Shlomo had also an open heart to the younger scientists and members of ISHNE by promoting them at his best and by organizing numerous educational sessions together with Wojciech Zareba. He held personal contacts and motivated young scientists to perform research and become active members of ISHNE. He was a mentor and friend of many young scientists by sending hundreds of letters encouraging them to send their papers to our official Journal, the ANE.

In our commemoration paper Harold Kennedy stated “We saw a joy in Shlomo´s following his academic commitment and passion to ISHNE as evidenced at his last ISHNE Congress in Timisoara in 2013, and his continuing efforts to promote international “friends” (as he would say) and goodwill. He was steadfast in his belief that our small meetings at the time of mega-meetings were a quality venue that should not give way to financial crises or a changing technological environment. This altruism in conflict with practicality was honed by a life of adverse circumstances, which he overcame physically and mentally and shared in private conversations with those of us fortunate enough to spend private time to hear of his survival in WW II and the early days of Israel”.

At the end we would like to remind all our members of ISHNE of Shlomo Stern´s last slide of his last official ISHNE Congress presentation 2013 in Timsoara, when he was summarizing the challenges of the future (Figure 5).

Figure 5: Summary of Shlomo Stern´s lecture on the history of ISHNE entitled: “ISHNE: A Glorious Past and A Challenging Future”

By Antonio Bayes de Luna, Harold L. Kennedy, Arthur J. Moss and Vinzenz Hombach