Clinical electrophysiology in the Netherlands: where do we stand?

For more than a century, Dutch scientists and clinicians have contributed importantly to the understanding of cardiac electrophysiology and to the diagnosis and treatment of cardiac rhythm disturbances. The first example supporting this statement that comes to mind is the development of a string galvanometer and the registration of the human electrocardiogram by Willem Einthoven in 1901 [1]. Almost 100 years after Einthoven’s Nobel prize in 1924 the ECG is still the most important tool for virtually everyone working in the field of cardiology. The first description of the total excitation of the human heart, recorded with hundreds of intramural electrodes implanted in an explanted, Langendorff perfused human heart stems from Dutch soil [2]. Similarly, the cradle of invasive electrophysiology stood in the Wilhelmina Gasthuis, where Wellens and associates, simultaneously with Coumel’s group in Paris, developed programmed stimulation that has become a standard approach to discern arrhythmia mechanisms [3]. In pacing, Dutch investigators played a central role, for example in a large study on appropriate pacemaker follow-up, as well as in the recent first-in-man studies of completely leadless pacemakers [4–6]. Hence, we look back at a glorious past, but what is the position of clinical electrophysiology in the Netherlands today, and what should we expect from the future? This issue of the Netherlands Heart Journal is focused on electrophysiology and aims at answering that very question. Having left the pioneering era behind us, the field of clin-