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In memoriam - Professor Hein Wellens

A pioneer in clinical electrophysiology and an unforgettable teacher

Hein Wellens.jpg "Prof. Hein Wellens died on June, 9, 2020. I met him in 1980, when I went to Maastricht, the Netherlands as a fellow in clinical electrophysiology, at a time when the first three fellows, Jeronimo Farre, David Ross and Isaac Wiener, had just left. I came when Pedro Brugada was there and Dennis Roy and Peter Friedman followed shortly thereafter. We all became friends based on our common goal to understand and study clinical arrhythmias. And it was clear to all of us that there was no better place than Maastricht under the leadership of Prof. Wellens. As a coworker of the late Professor Dirk Durrer in Amsterdam, the Netherlands, Hein Wellens was involved in the early developments of programmed electrical stimulation of the heart in patients with the Wolff-Parkinson-White syndrome. In these patients, he showed for the very first time that tachycardias could systematically be initiated and terminated by critically timed premature electrical stimuli. In 1971, Hein Wellens reported on the use of programmed electrical stimulation of the heart in patients with atrial flutter, AV nodal tachycardia, and accessory atrioventricular connections. In 1972, he showed that ventricular tachycardia could also reproducibly be initiated and terminated by timed premature stimuli.

In 1977, he had moved to the new University of Limburg in Maastricht, Netherlands, as chief of cardiology to develop academic cardiology there after many years in Amsterdam and a short stay in Liege with Henri Kulbertus. Hein Wellens started in Maastricht from scratch and turned the clinic into one of the world’s leading centers of clinical electrophysiology.

Hein Wellens was a physician who took care of his patients and loved to discuss patients very intensively every morning in the morning rounds. He was a scientist. He encouraged us in these early days of clinical electrophysiology to analyze – beat by beat! – hundreds of meters of intracardiac recordings and surface ECGs collected from hours of EP study. We had to measure every interval, and we had to write an EP protocol – both the EP analysis and the report took us 2 weeks to complete. We had to present our reports to Prof. Wellens and to explain our findings – beat by beat! And we had to explain the underlying mechanism of every spontaneous or induced reentrant beat or tachycardia. It was all mechanisms. We learned from him and together we described new mechanisms. I remember my first paper was on new mechanistic observations in antidromic circus movement tachycardia. Mechanisms and EP phenomena – that was his passion. This was what describes the Maastricht school best. He was open for randomized trials, but it was not the most important thing for him to compare one strategy against another strategy. Hein Wellens loved the phenomenon, the new observation. He was a teacher – for me he was the teacher, one of the world’s most talented teachers I ever met. And his talent for teaching made him a fascinating speaker. To speak and to teach – that was the world of Prof. Wellens. He was a Professor. That is what he was for me and will ever be. He was born to teach. He was a teacher of clinical electrophysiology and the surface ECG and the interaction of both. But it was not only the ECG and arrhythmias but the ECG in general that fascinated him. Every little change in the surface electrocardiogram was the clue for something clinically important which should not be missed. He sharpened our senses to look into the detail. He made so many observations which became the gold standard in cardiology – including the Wellens’ syndrome. He was not a politician and he was not everybody’s darling.

And Hein Wellens met Mark Josephson – two different characters but one common goal: if you are a doctor, take cardiology, take electrophysiology and electrocardiography seriously. Try to be the best. They were the best and their combination was unique, outstanding, unforgettable. Two outstanding physicians, scientists, and teachers. Their teaching course “How to approach complex arrhythmias” was a must for every young cardiologist. A week of work, a stressful week. A bit of relaxation in the evening to recover for the next day. Hein and Mark showed what one could read from the surface ECG supported by EP tracings – at least this was what people never forgot: there is somebody in the world who can read a surface ECG. They were kind but could be demanding. You better did your homework! Thirty years of teaching on both sites of the ocean. An irretrievable experience for hundreds of young doctors. But there is hope, as Riccardo Cappato wrote me – they both will start teaching EP to the angels.

I would like to thank Prof. Wellens for what he gave to me, to all of us and to the world – respect, honesty, understanding, humility and friendship. Sartre said “Vous choisissez qui vous voulez etre”. Hein took the right choice. It is an honor to have known him. He will be sorely missed. Our thoughts are with Inez, Floor, Willemijn, Maarten, Jooske and the family."

Professor Karl-Heinz Kuck, EHRA President, 2013-2015