Professor Hein JJ Wellens, In memoriam

The untimely demise of Professor Hein Wellens (1935–2020), Emeritus Professor of Cardiology, University of Maastricht, Maastricht, the Netherlands on 9th June after a brief intractable illness pushed the EP world into a vortex of gloom. Both authors (YL and AN) have shared a long personal bond with one of the founders of clinical cardiac electrophysiology, who pioneered programmed electrical stimulation of the heart. We grieve our personal and professional loss. Professor’s personality was amazing; alternating between an astute physician, clinical scientist, master teacher and a mentor to numerous cardiology fellows and young colleagues. After five decades of learning from the Guru, no clinician could have asked for a better role model.

Professor Wellens has to his credit a prolific list of publications in Arrhythmology, more than a 1000 publications which have been cited more than 35,000 times, a feat not easy to emulate! His writings have involved almost every aspect of arrhythmia care; supraventricular tachycardias, sudden cardiac death, anti-arrhythmic drugs, electrophysiology studies unravelling arrhythmia mechanisms, newer cardiac implantable electrical devices and many more. His involvement in his publications was absolute, whether as a singular author, lead author or stimulating or collaborating on an idea that would have germinated anywhere in the world. His emphasis remained on good observation, bringing in new meaningful insights through clinical studies and case reports, never skirting the physiology of arrhythmogenic mechanisms. That’s probably why he also enjoyed authoring reviews, editorials and guidelines; but less so when it came to RCTs and meta-analyses.

He had the art of making complex concepts easier to understand. He also successfully translated insights gained from electrophysiology to the simple 12-lead ECG. Professor Wellens’ contributions and teachings in ECG analysis are legendary. Not only for arrhythmias, but even in acute coronary syndrome and heart failure, he introduced unique ECG interpretations. It is thus ironic, but not surprising, that the Wellens syndrome refers to a pattern in acute ischemia! Professor Wellens’ passion for arrhythmology can be gleaned from the fact that almost 35% of his manuscripts were from the good old St. Annadal Ziekenhuis where he laid the foundation of Cardiology department in Maastricht and close to 25% of his manuscripts came after retiring as a Chair from the state-of-the-art department at Academisch Ziekenhuis Maastricht. This numeric should encourage our younger colleagues to publish science, as much as they read and quote it.

The EP school of Professor Wellens transcended geographies. In the 90s, India desperately needed trained clinical cardiac electrophysiologists. In those times there were hardly any institutes offering such training programs. Both, YL in 1993 and later AN in 1998 had a life-time of an opportunity to train as a fellow in Maastricht. The working day typically started with a morning meeting where the cardiology fellows from the department presented all types of cases. After the staff cardiologists debated on various aspects of investigations and treatment, Professor Wellens would impart his take-home messages. Thereafter, the learning scene would shift to the EP lab. We remain grateful to Professor Wellens; time spent in Maastricht allowed us interaction with the attending cardiologists in the EP lab, opportunity to review many carefully stored EP studies from past, access (including net access) to well-equipped libraries, discussions with co-fellows from different countries and importantly publish our research under Professor’s guidance. We revised our manuscripts umpteen times before submitting to Professor Wellens, he in turn would meticulously go through them categorically pointing out how they could be improved. He was empathetic when caring for his fellows; whether that meant a possibility to take your accepted abstract to an international conference or springing, unexpectedly, a personal favour which warmed our hearts! There are a number of instances that both of us could affectionately point out.

Wellens’ iconic status in the world did not prevent him from uplifting the arrhythmia care at the Department of Cardiology, King Edward VII Memorial Hospital, Mumbai. One day, in 1996, he landed in our department with a brand-new EP system to end our tedious journey with the then available hardware. This EP system supported thousands of ablation procedures in the next 15 years! Since then he visited India on several occasions, particularly at the behest of YL, delivering his widely sought-after ECG lectures at the meetings of the Cardiological Society of India and Indian Society of Electrocardiology. These were liked by physicians, interventional cardiologists and electrophysiologists from all over India. YL had maintained a hotline with the Professor; publishing collaboratively on topics such as Mahaim pathways and atrial tachycardias ablated from the non-coronary sinus, as also ECG/EP vignettes; and discussing interesting and perplexing cases. Despite his discomfort in the recent illness, he wrote to us all. AN was greatly comforted when the Professor assured him that he closely watched his career on return to India. May be it is his love for cricket and field-hockey that strikes a common chord with Indians!

We believe a doyen such as Professor Wellens truly belongs to the entire world. Our Guru will be remembered not only for his sheer brilliance and fervent support to the evolution and sharing of knowledge - thereby improving patient care - but also, more importantly, for making us feel blessed through his unrestrained and empathetic interactions which continued till the very end. Not even the most recent version of hologram technology would capture all aspects of Professor Wellens for future generations, that’s why we feel rewarded!

Declaration of competing interest

Nothing to declare.