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Hybrid ablation: a team effort with better outcomes

Hybrid ablation: a team effort with better outcomes

17 February 2023

The hybrid ablation treatment developed at Maastricht UMC+ leads to better results in persistent atrial fibrillation than the standard treatment, catheter ablation.

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People with diabetes who control risk factors are less likely to develop depression

People with diabetes who control risk factors are less likely to develop depression

9 February 2023

Someone with diabetes has an increased risk of depression, but may be able to limit it by addressing risk factors such as unhealthy diet and high blood pressure. This has emerged from research by scientists at Maastricht UMC+ who analyzed data from nearly 78,000 people.

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Carim Maastricht
Carim Maastricht

Rachel ter Bekke

Post doc

After having obtained my medical degree at the university of Antwerp, I completed my Cardiology specialization in the Maastricht University Medical Center. Thereafter, I performed a clinical fellowship in Electrophysiology and Cardiogenetics to obtain level 2 of invasive electrophysiology and cardiac pacing endorsed by the EHRA. I have always been fascinated by ventricular tachyarrhythmias, especially in the genetically-susceptible heart. In 2018, I successfully defended my PhD thesis entitled: “Ventricular Arrhythmogenesis in the Genetically-Susceptible Heart: Time to Change Concepts of Mechanisms and Management” under guidance of prof. dr. Paul Volders. I demonstrated that the combined assessment of electrical and mechanical abnormalities (alias the electromechanical window) in patients with the long-QT syndrome provide superior sudden cardiac death risk stratification than the traditionally used QTc. I further investigated electromechanical trigger-substrate interactions prior to sympathetically-induced arrhythmias in a canine drug-induced long-QT syndrome model (and was awarded the EWGCCE Travel Award). Furthermore, with the investigation of complex genotype/phenotype relations in a 16-generation SCN5A-mutation founder population with sudden cardiac death I was a finalist at the Young Investigator Awards of the HRS. My expertise lies in cardiac cellular & clinical electrophysiology, inherited arrhythmia syndromes, and antiarrhythmic management including invasive ablation techniques of complex ventricular arrhythmias.

My research ambition is to bring the field of complex arrhythmia management forward. To this aim, I strongly believe multimodality imaging using ECG-imaging, 3D-MRI and invasive electroanatomical assessment is key, next to deep pheno- and genotyping and high-resolution (non)invasive electromechanical profiling. To further our understanding the role mechano-electric feedback plays in ventricular arrhythmogenesis I will pioneer in novel invasive and noninvasive methods to depict electromechanical behavior with high spatiotemporal resolution at rest and after smart provocation; both in drug-induced animal models and in patients with the long-QT syndrome. For this research proposal I was awarded the prestigious Veni grant by ZonMw in 2019. This innovative work is expected to have major impact for other mechanosensitive cardiac diseases.

Rachel-ter-bekke

Department of Cardiology
Address: P. Debyelaan 25, 6229 HX Maastricht
Room number: 3.B2.025
T: +31 (0)43 387 70 95

  • 2022
    • Odening, K. E., van der Linde, H. J., Ackerman, M. J., Volders, P. G. A., & Ter Bekke, R. M. A. (2022). Electromechanical reciprocity and arrhythmogenesis in long-QT syndrome and beyond. European Heart Journal, 43(32), 3018-3028. https://doi.org/10.1093/eurheartj/ehac135
    • Verhaert, D. V. M., Linz, D., Chaldoupi, S. M., Westra, S. W., den Uijl, D. W., Philippens, S., Kerperien, M., Habibi, Z., Vorstermans, B., ter Bekke, R. M. A., Beukema, R. J., Evertz, R., Hemels, M. E. W., Luermans, J. G. L. M., Manusama, R., Lankveld, T. A. R., van der Heijden, C. A. J., Bidar, E., Hermans, B. M., ... Schotten, U. (2022). Rationale and Design of the ISOLATION Study: A Multicenter Prospective Cohort Study Identifying Predictors for Successful Atrial Fibrillation Ablation in an Integrated Clinical Care and Research Pathway. Frontiers in cardiovascular medicine, 9, [879139]. https://doi.org/10.3389/fcvm.2022.879139
    • Henkens, M. T. H. M., Raafs, A. G., Verdonschot, J. A. J., Linschoten, M., van Smeden, M., Wang, P., van der Hooft, B. H. M., Tieleman, R., Janssen, M. L. F., Ter Bekke, R. M. A., Hazebroek, M. R., van der Horst, I. C. C., Asselbergs, F. W., Magdelijns, F. J. H., Heymans, S. R. B., & CAPACITY-COVID collaborative consortium (2022). Age is the main determinant of COVID-19 related in-hospital mortality with minimal impact of pre-existing comorbidities, a retrospective cohort study. BMC Geriatrics, 22(1), [184]. https://doi.org/10.1186/s12877-021-02673-1
    • Cluitmans, M., Coll-Font, J., Erem, B., Bear, L., Nguyên, U. C., Ter Bekke, R., Volders, P. G. A., & Brooks, D. (2022). Spatiotemporal approximation of cardiac activation and recovery isochrones. Journal of Electrocardiology, 71, 1-9. https://doi.org/10.1016/j.jelectrocard.2021.12.007
  • 2021
    • Cluitmans, M. J. M., Bear, L. R., Nguyên, U. C., van Rees, B., Stoks, J., Ter Bekke, R. M. A., Mihl, C., Heijman, J., Lau, K. D., Vigmond, E., Bayer, J., Belterman, C. N. W., Abell, E., Labrousse, L., Rogier, J., Bernus, O., Haïssaguerre, M., Hassink, R. J., Dubois, R., ... Volders, P. G. A. (2021). Noninvasive detection of spatiotemporal activation-repolarization interactions that prime idiopathic ventricular fibrillation. Science Translational Medicine, 13(620), [eabi9317]. https://doi.org/10.1126/scitranslmed.abi9317
    • Van Rees, B., Stoks, J., Nguyen, Y. C., Ter Bekke, R. M. A., Mihl, C., Cluitmans, M., & Volders, P. G. A. (2021). Local areas of earlier repolarization cause epicardial repolarization heterogeneity in patients with apparently idiopathic ventricular fibrillation. European Heart Journal, 42, 326-326.
    • Pluymaekers, N. A. H. A., Dudink, E. A. M. P., Weijs, B., Vernooy, K., Hartgerink, D. E. J., Jacobs, J. S., Erkuner, O., Marcks, N. G. H. M., van Cauteren, Y. J. M., Dinh, T., ter Bekke, R. M. A., Sels, J. E. M. W., Delnoij, T. S. R., Geyik, Z., Driessen, R. G. H., Linz, D. K., den Uijl, D. W., Crijns, H. J. G. M., & Luermans, J. G. L. M. (2021). Clinical determinants of early spontaneous conversion to sinus rhythm in patients with atrial fibrillation. Netherlands Heart Journal, 29(5), 255-261. https://doi.org/10.1007/s12471-020-01528-5
    • Holtackers, R. J., Gommers, S., Van De Heyning, C. M., Mihl, C., Smink, J., Higgins, D. M., Wildberger, J. E., & ter Bekke, R. M. A. (2021). Steadily Increasing Inversion Time Improves Blood Suppression for Free-Breathing 3D Late Gadolinium Enhancement MRI With Optimized Dark-Blood Contrast. Investigative Radiology, 56(5), 335-340. https://doi.org/10.1097/RLI.0000000000000747
    • Holtackers, R. J., Ter Bekke, R. M. A., Bijvoet, G. P., Gommers, S., Chiribiri, A., & Lorusso, R. (2021). A Boolean Dilemma: True or False Aneurysm?JACC. Case reports, 3(1), 112-116. https://doi.org/10.1016/j.jaccas.2020.09.055
  • 2020
    • Haanschoten, D. M., Vernooy, K., Beukema, R. J., Szili-Torok, T., ter Bekke, R. M. A., Khan, M., de Jong, J. S. S. G., Otten, A. M., Adiyaman, A., Smit, J. J. J., Delnoy, P. P. H. M., Misier, A. R. R., & Elvan, A. (2020). Elimination of Benign Ventricular Premature Beats or Ventricular Tachycardia with Catheter Ablation versus Two Different Optimal Antiarrhythmic Drug Treatment Regimens (Sotalol or Verapamil/Flecainide). Cardiology, 145(12), 795-801. https://doi.org/10.1159/000509661
    • Pinto-Sietsma, S. J., Flossdorf, M., Buchholz, V. R., Offerhaus, J., Bleijendaal, H., Beudel, M., Volders, P. G. A., ter Bekke, R. M. A., Dormans, T., Zwetsloot, P. P., de Jager, P., Massberg, S., Ramer, P., Wendtner, C., Hoffmann, E., Rothe, K., Feihl, S., Kessler, T., Pinto, Y. M., ... Pinto, Y. (2020). Antihypertensive drugs in COVID-19 infection. European Heart Journal-Cardiovascular Pharmacotherapy, 6(6), 415-416. https://doi.org/10.1093/ehjcvp/pvaa058
    • Molenaar, M. M. D., Hesselink, T., ter Bekke, R. M. A., Scholten, M. F., Manusama, R., Pison, L., Brusse-Keizer, M., Kraaier, K., ten Haken, B., Grandjean, J. G., Timmermans, C. C., & van Opstal, J. M. (2020). Shorter RSPV cryoapplications result in less phrenic nerve injury and similar 1-year freedom from atrial fibrillation. Pacing and Clinical Electrophysiology, 43(10), 1173-1179. https://doi.org/10.1111/pace.14062
    • Mariani, S., Napp, L. C., Lo Coco, V., Delnoij, T. S. R., Luermans, J. G. L. M., ter Bekke, R. M. A., Timmermans, C., Li, T., Dogan, G., Schmitto, J. D., Maessen, J., Maesen, B., & Lorusso, R. (2020). Mechanical circulatory support for life -threatening arrhythmia: A systematic review. International Journal of Cardiology, 308, 42-49. https://doi.org/10.1016/j.ijcard.2020.03.045
    • Haanschoten, D. M., Elvan, A., Postema, P. G., Smit, J. J. J., Adiyaman, A., Ter Bekke, R. M. A., Asaad, N., Aanhaanen, W. T. J., Misier, A. R. R., Delnoy, P. P. H. M., Crijns, H. J. G. M., & Wilde, A. A. M. (2020). Catheter ablation in highly symptomatic Brugada patients: a Dutch case series. Clinical research in cardiology, 109(5), 560-569. https://doi.org/10.1007/s00392-019-01540-9
    • ter Bekke, R. M. A., & Volders, P. G. A. (2020). Haloperidol and sudden death in first acute myocardial infarction. IJC Heart & Vasculature, 26, [100482]. https://doi.org/10.1016/j.ijcha.2020.100482
  • 2019
    • ter Bekke, R. M. A., Moers, A. M. E., de Jong, M. M. J., Johnson, D. M., Schwartz, P. J., Vanoli, E., & Volders, P. G. A. (2019). Proarrhythmic proclivity of left-stellate ganglion stimulation in a canine model of drug-induced long-QT syndrome type 1. International Journal of Cardiology, 286, 66-72. https://doi.org/10.1016/j.ijcard.2019.01.098
    • Molenaar, M. M. D., Timmermans, C. C., Hesselink, T., Scholten, M. F., ter Bekke, R. M. A., Luermans, J. G. L. M., Brusse-Keizer, M., Kraaier, K., ten Haken, B., Grandjean, J. G., Vernooy, K., & van Opstal, J. M. (2019). Shorter cryoballoon applications times do effect efficacy but result in less phrenic nerve injury: Results of the randomized 123 study. Pacing and Clinical Electrophysiology, 42(5), 508-514. https://doi.org/10.1111/pace.13626
  • 2018
    • Ter Bekke, R. M. A., David, M., Krapels, I. P. C., Crijns, H. J. G. M., & Volders, P. G. A. (2018). Beauty and the beat: A complicated case of multifocal ectopic Purkinje-related premature contractions. HeartRhythm Case Reports, 4(9), 429-433. https://doi.org/10.1016/j.hrcr.2018.05.010
    • ter Bekke, R., & Volders, C. A. A. (2018). Het HeArt-project. Tijdschrift voor Gezondheidswetenschappen, 96(5), 184-186. https://doi.org/10.1007/s12508-018-0155-9
  • 2017
    • ter Bekke, R. M. A., Isaacs, A., Barysenka, A., Hoos, M. B., Jongbloed, J. D. H., Hoorntje, J. C. A., Patelski, A. S. M., Helderman-van den Enden, A. T. J. M., van den Wijngaard, A., Stoll, M., & Volders, P. G. A. (2017). Heritability in a SCN5A-mutation founder population with increased female susceptibility to non-nocturnal ventricular tachyarrhythmia and sudden cardiac death. Heart Rhythm, 14(12), 1873-1881. https://doi.org/10.1016/j.hrthm.2017.07.036
    • Klaeboe, L. G., Haland, T. F., Leren, I. S., ter Bekke, R. M. A., Brekke, P. H., Rosjo, H., Omland, T., Gullestad, L., Aakhus, S., Haugaa, K. H., & Edvardsen, T. (2017). Prognostic Value of Left Ventricular Deformation Parameters in Patients with Severe Aortic Stenosis: A Pilot Study of the Usefulness of Strain Echocardiography. Journal of the American Society of Echocardiography, 30(8), 727-735.e1. https://doi.org/10.1016/j.echo.2017.04.009
  • 2016
    • Wellens, H., Lindemans, F. W., Houben, R. P., Gorgels, A., Volders, P. G., ter Bekke, R. M. A., & Crijns, H. J. (2016). Improving survival after out-of-hospital cardiac arrest requires new tools. European Heart Journal, 37(19), 1499-1503. https://doi.org/10.1093/eurheartj/ehv485
  • 2015
    • Kumar, N., Abbas, M. M., ter Bekke, R. M. A., de Jong, C. M. M. J. F., Choudhury, R., Bisht, O., Philippens, S., & Timmermans, C. (2015). Maastricht experience with the second generation endoscopic laser balloon ablation system for the atrial fibrillation treatment. Netherlands Heart Journal, 23(7-8), 373-374. https://doi.org/10.1007/s12471-015-0703-8
    • ter Bekke, R. M. A., Haugaa, K. H., van den Wijngaard, A., Bos, J. M., Ackerman, M. J., Edvardsen, T., & Volders, P. G. A. (2015). Electromechanical window negativity in genotyped long-QT syndrome patients: relation to arrhythmia risk. European Heart Journal, 36(3), 179-186. https://doi.org/10.1093/eurheartj/ehu370
  • 2013
    • Zusterzeel, R., ter Bekke, R. M. A., Volders, P. G. A., Leijten, F. M. M., van den Wijngaard, A., Serroyen, J., & Gorgels, A. P. M. (2013). Right-Ventricular Enlargement in Arrhythmogenic Right-Ventricular Cardiomyopathy Is Associated with Decreased QRS Amplitudes and T-Wave Negativity. Annals of Noninvasive Electrocardiology, 18(6), 555-563. https://doi.org/10.1111/anec.12080
  • 2012
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