Hein Wellens
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Henrick Joan Joost (Hein J. J. ) Wellens, M.D., (1935–2020) was a Dutch
cardiologist Cardiology () is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery di ...
who is considered one of the founding fathers of clinical
cardiac electrophysiology Cardiac electrophysiology is a branch of cardiology and Basic Science, basic science focusing on the electrical activities of the heart. The term is usually used in clinical context, to describe studies of such phenomena by invasive (intracardiac ...
- a discipline which enables patients with
cardiac The heart is a muscular organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrients to the tissu ...
arrhythmia Arrhythmias, also known as cardiac arrhythmias, are irregularities in the cardiac cycle, heartbeat, including when it is too fast or too slow. Essentially, this is anything but normal sinus rhythm. A resting heart rate that is too fast – ab ...
s to have catheter electrode mapping and ablation. Wellens was known among European cardiologists as "the giant of Maastricht" and for many years was associated with the University of Limburg School of Medicine in
Maastricht Maastricht ( , , ; ; ; ) is a city and a Municipalities of the Netherlands, municipality in the southeastern Netherlands. It is the capital city, capital and largest city of the province of Limburg (Netherlands), Limburg. Maastricht is loca ...
, Netherlands. At his department of cardiology, many future clinical cardiac electrophysiologists trained from 1976 until his retirement in 2002.


Early life and education

Wellens was born on 13 November 1935 in
The Hague The Hague ( ) is the capital city of the South Holland province of the Netherlands. With a population of over half a million, it is the third-largest city in the Netherlands. Situated on the west coast facing the North Sea, The Hague is the c ...
, the Netherlands. He studied medicine at the
University of Leiden Leiden University (abbreviated as ''LEI''; ) is a public research university in Leiden, Netherlands. Established in 1575 by William, Prince of Orange as a Protestant institution, it holds the distinction of being the oldest university in the Neth ...
. Following two years of
internal medicine Internal medicine, also known as general medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of diseases in adults. Its namesake stems from "treatment of diseases of ...
, he did three years of
cardiology Cardiology () is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery di ...
in the Wilhelmina Gasthuis Hospital of the
University of Amsterdam The University of Amsterdam (abbreviated as UvA, ) is a public university, public research university located in Amsterdam, Netherlands. Established in 1632 by municipal authorities, it is the fourth-oldest academic institution in the Netherlan ...
under the guidance of Prof Dirk Durrer.


Contributions to medicine

In the late 1960s, at the University Hospital of Amsterdam, Wellens investigated patients with cardiac arrhythmias by placing cardiac catheters allowing the recording of the electrical activation of the heart at different sites. By connecting these catheters to a pacing device, he showed that it was possible to initiate and terminate
cardiac arrhythmias Arrhythmias, also known as cardiac arrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. Essentially, this is anything but normal sinus rhythm. A resting heart rate that is too fast – above 100 beats ...
, localize the site of origin of the arrhythmia, and discover the mechanism. By using this approach (called programmed electrical stimulation) Wellens not only unraveled mechanisms and localization of arrhythmias in the Wolff-Parkinson-White syndrome but also other types of supraventricular tachycardias. In the early 1970s, he showed that programmed electrical stimulation of the heart could also be used to study the mechanism and localization of
ventricular tachycardia Ventricular tachycardia (V-tach or VT) is a cardiovascular disorder in which fast heart rate occurs in the ventricles of the heart. Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple ...
. In 1971 he published the first book on programmed stimulation of the heart in patients with tachycardias. In 1973 Wellens was appointed Professor of Cardiology at the University of Amsterdam. At that time his new approach allowed the investigation of the effect of drugs on the tachycardia mechanism, the development of new therapeutic strategies such as the termination of tachycardias by specially designed
pacemakers A pacemaker, also known as an artificial cardiac pacemaker, is an implanted medical device that generates electrical pulses delivered by electrodes to one or more of the chambers of the heart. Each pulse causes the targeted chamber(s) to co ...
, the surgical removal or isolation of the tachycardia substrate, and ultimately cure of cardiac arrhythmias by catheter ablation. In 1971, he reported on the use of programmed electrical stimulation of the heart in patients with
atrial flutter Atrial flutter (AFL) is a common abnormal heart rhythm that starts in the atrial chambers of the heart. When it first occurs, it is usually associated with a fast heart rate and is classified as a type of supraventricular tachycardia (SVT). ...
, AV nodal tachycardia, and accessory atrioventricular connections. In 1972, he showed that the arrhythmia of patients with
ventricular tachycardia Ventricular tachycardia (V-tach or VT) is a cardiovascular disorder in which fast heart rate occurs in the ventricles of the heart. Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple ...
could also reproducibly be initiated and terminated by timed premature stimuli. These investigations were the basis for the new surgical and pacing approaches to the treatment of cardiac arrhythmias that became known as "
cardiac electrophysiology Cardiac electrophysiology is a branch of cardiology and Basic Science, basic science focusing on the electrical activities of the heart. The term is usually used in clinical context, to describe studies of such phenomena by invasive (intracardiac ...
".Maloney, James. "Biography of Hein J. J. Wellens." ''Heart Rhythm Society Online'', Internet, , May 19, 1995. Wellens left Amsterdam in 1977 to become Professor and Chairman of the Department of Cardiology at the Academic Hospital of the new
Maastricht University Maastricht University (abbreviated as UM; ) is a public university, public research university in Maastricht, Netherlands. Founded in 1976, it is the second youngest of the thirteen List of universities in the Netherlands, Dutch universities. In ...
. There he created his school of arrhythmology, educating many cardiologists from all over the world in the period from 1977 to 2001. After returning to their home country, many became leaders in cardiology. Wellens was a student Professor Dirk Durrer in Amsterdam and participated in the early development of programmed electrical stimulation of the heart in patients with
Wolff–Parkinson–White syndrome Wolff–Parkinson–White syndrome (WPWS) is a disorder due to a specific type of problem with the electrical system of the heart involving an accessory pathway able to conduct electrical current between the atria and the ventricles, thus byp ...
. In these patients,
cardiac arrhythmia Arrhythmias, also known as cardiac arrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. Essentially, this is anything but normal sinus rhythm. A resting heart rate that is too fast – above 100 beat ...
s were shown to be initiated and terminated by critically timed premature beats. Wellens also demonstrated that the reproducible initiation and termination of arrhythmias by programmed electrical stimulation of the heart allowed the study of the effect of antiarrhythmic drugs on the mechanism of the arrhythmia. In 1977, he moved to the new University of Limburg in Maastricht, Netherlands, to develop academic cardiology there. He created an internationally known center for the study and treatment of cardiac arrhythmias.


Later years

In 1990 Wellens became a member of the
Royal Netherlands Academy of Arts and Sciences The Royal Netherlands Academy of Arts and Sciences (, KNAW) is an organization dedicated to the advancement of science and literature in the Netherlands. The academy is housed in the Trippenhuis in Amsterdam. In addition to various advisory a ...
. He directed the Interuniversity Cardiological Institute of the Netherlands (ICIN) from 1993 to 2003, an Institute of the Royal Netherlands Academy of Arts and Sciences, in which the Dutch research activities in cardiovascular research are combined at the national level. He wrote or co-authored over 670 peer-reviewed articles, 254 chapters in books, and was the author or editor of 21 books on cardiology. In collaboration with
Mark Josephson Mark E. Josephson (1943-2017) was an American cardiologist and writer, who was in the 1970s one of the American pioneers of the medical cardiology subspecialty of cardiac electrophysiology. His book titled ''Clinical Cardiac Electrophysiology: T ...
from United States, he taught advanced ECG and electrophysiology concepts at international Wellens and Josephson Advanced ECG course.


Death

Wellens died on 9 June 2020 of metastatic gastric cancer. Articles in memoriam of Hein Wellens were published by
European Society of Cardiology The European Society of Cardiology (ESC) is an independent Nonprofit organisation, non-profit, non-governmental professional association that works to advance the prevention, diagnosis and management of diseases of the heart and blood vessels, a ...
, authored by past president of European Heart Rhythm Association Karl-Heinz Kuck and by Latin American Heart Rhythm Society, authored by Josep Brugada and Jacob Atié.


Eponyme

Wellens syndrome, an electrocardiographic pattern indicative of critical narrowing in left anterior descending
artery An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...
of the heart, is named after Hein Wellens who first described this pattern in 1982.


References

{{DEFAULTSORT:Wellens, Hein 1935 births 2020 deaths Cardiac electrophysiologists Dutch cardiologists Academic staff of Maastricht University Members of the Royal Netherlands Academy of Arts and Sciences Physicians from The Hague University of Amsterdam alumni Academic staff of the University of Amsterdam