This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wellens, H. J. Search for Related Content PubMed PubMed Citation Articles by Wellens, H. J. Related Collections Electrophysiology

Advances in Arrhythmia and Electrophysiology

Forty Years of Invasive Clinical Electrophysiology

1967–2007

Hein J. Wellens, MD

From the Cardiovascular Research Center Maastricht, Maastricht, the Netherlands.

Correspondence to Hein J. Wellens, MD, Cardiovascular Research Center Maastricht, 21 Henric van Veldekeplein, 6211 TG, Maastricht, The Netherlands. E-mail hwellens@xs4all.nl

Key Words: arrhythmia • tachycardia • electrophysiology

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In 2007, we marked the 40th anniversary of the birth of invasive clinical electrophysiology. Of course, before 1967, cardiac arrhythmias were documented electrocardiographically, and their possible mechanisms were analyzed ingeniously and explained beautifully by giants such as Katz and Pick,¹ Scherf and Schott,² and Bellet.³

In the 1940s and 1950s, Hecht,⁴ Latour and Puech,⁵ and Giraud et al⁶ used catheters to measure intracardiac electric activity and to record the sequence of cardiac activation. In 1958, Furman and Robinson⁷ showed that in patients with atrioventricular block, the heart could be stimulated by connecting an intraventricular catheter to a stimulator.

	The Early Years

 
In 1967, the analysis of the site of origin and mechanism of cardiac arrhythmias became possible in the intact human heart through the use of programmed electric stimulation combined with intracardiac activation mapping. Independently, Durrer et al⁷ in Amsterdam (in patients with the Wolff-Parkinson-White syndrome) and Coumel and coworkers⁸ in Paris (in a patient with an atrioventricular junctional tachycardia) showed that by connecting intracardiac catheters to a versatile stimulator, it was possible to reproducibly initiate and terminate clinically occurring tachycardias and to identify the site of origin of the tachycardia and, in the case of a reentrant mechanism, the pathway of the arrhythmia by placing catheters at different sites in the heart.^8,9 Soon after, on both sides of the Atlantic, this technique was used to unravel the place of origin of different types of supraventricular tachycardias.^10–14 The first book on the use of programmed stimulation of the heart in the analysis of . . . [Full Text of this Article]