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.

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

  • 2024
    • Stevens, R. R. F., Hazelaar, C., Bogowicz, M., Ter Bekke, R. M. A., Volders, P. G. A., Verhoeven, K., de Ruysscher, D., Verhoeff, J. J. C., Fast, M. F., Mandija, S., Cvek, J., Knybel, L., Dvorak, P., Blanck, O., & van Elmpt, W. (2024). A Framework for Assessing the Effect of Cardiac and Respiratory Motion for Stereotactic Arrhythmia Radioablation Using a Digital Phantom With a 17-Segment Model: A STOPSTORM.eu Consortium Study. International Journal of Radiation Oncology Biology Physics, 118(2), 533-542. https://doi.org/10.1016/j.ijrobp.2023.08.059
  • 2023
    • Garcia, J. G., Arya, A., Dinov, B., Bollmann, A., ter Bekke, R. M. A., Vernooy, K., Dagres, N., Hindricks, G., & Darma, A. (2023). Impact of repeat ablation of ventricular tachycardia in patients with structural heart disease. EP Europace, 26(1), Article euad367. https://doi.org/10.1093/europace/euad367
    • Verheul, L. M., van der Ree, M. H., Groeneveld, S. A., Mulder, B. A., Christiaans, I., Kapel, G. F. L., Alings, M., Bootsma, M., Barge-Schaapveld, D. Q. C. M., Balt, J. C., Yap, S.-C., Krapels, I. P. C., Ter Bekke, R. M. A., Volders, P. G. A., van der Crabben, S. N., Postema, P. G., Wilde, A. A. M., Dooijes, D., Baas, A. F., & Hassink, R. J. (2023). The genetic basis of apparently idiopathic ventricular fibrillation: a retrospective overview. EP Europace, 25(11), Article euad336. https://doi.org/10.1093/europace/euad336
    • Kaya, Y. S., Stoks, J., Gommers, S., Holtackers, R. J., Duijsings, R., Vernooy, K., Volders, P., & Ter Bekke, R. (2023). Optimal pixel signal intensity threshold for the assessment of endocardial left-ventricular scar by 3D dark blood MRI compared to bipolar voltage electro-anatomical mapping. European Heart Journal, 44.
    • ter Bekke, R. M. A., de Schouwer, K., Conti, S., Claes, G. R. F., Vanoevelen, J., Gommers, S., Helderman-van den Enden, A. T. J. M., & Brunner-LaRocca, H.-P. (2023). Juvenile-onset multifocal atrial arrhythmias, atrial standstill and compound heterozygosity of genetic variants in TAF1A: sentinel event for evolving dilated cardiomyopathy-a case report. European Heart Journal - Case Reports, 7(6), Article ytad255. https://doi.org/10.1093/ehjcr/ytad255
    • Rijks, J. H. J., Lankveld, T., Manusama, R., Broers, B., van Stipdonk, A. M. W., Chaldoupi, S. M., ter Bekke, R. M. A., Schotten, U., Linz, D., Luermans, J. G. L. M., & Vernooy, K. (2023). Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation. Journal of Clinical Medicine, 12(12), Article 4028. https://doi.org/10.3390/jcm12124028
    • Nies, H. M. J. M., Martens, B., Gommers, S., Bijvoet, G. P., Wildberger, J. E., Ter Bekke, R. M. A., Holtackers, R. J., & Mihl, C. (2023). Myocardial Scar Detection Using High-Resolution Free-Breathing 3D Dark-Blood and Standard Breath-Holding 2D Bright-Blood Late Gadolinium Enhancement MRI: A Comparison of Observer Confidence. Topics in Magnetic Resonance Imaging, 32(3), 27-32. https://doi.org/10.1097/RMR.0000000000000304
    • Isaacs, A., Barysenka, A., ter Bekke, R. M. A., den Enden, A. T. J. M. H., van den Wijngaard, A., Volders, P. G. A., & Stoll, M. (2023). Standing genetic variation affects phenotypic heterogeneity in an SCN5A-mutation founder population with excess sudden cardiac death. Heart Rhythm, 20(5), 720-727. https://doi.org/10.1016/j.hrthm.2023.02.004
    • Cluitmans, M. J. M., Bayer, J., Bear, L. R., Ter Bekke, R. M. A., Heijman, J., Coronel, R., & Volders, P. G. A. (2023). The circle of reentry: Characteristics of trigger-substrate interaction leading to sudden cardiac arrest. Frontiers in Cardiovascular Medicine, 10, Article 1121517. https://doi.org/10.3389/fcvm.2023.1121517
    • Grehn, M., Mandija, S., Miszczyk, M., Krug, D., Tomasik, B., Stickney, K. E., Alcantara, P., Alongi, F., Anselmino, M., Aranda, R. S., Balgobind, B. V., Boda-Heggemann, J., Boldt, L. H., Bottoni, N., Cvek, J., Elicin, O., De Ferrari, G. M., Hassink, R. J., Hazelaar, C., ... Verhoeff, J. (2023). STereotactic Arrhythmia Radioablation (STAR): the Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary consortium (STOPSTORM.eu) and review of current patterns of STAR practice in Europe. EP Europace, 25(4), 1284-1295. https://doi.org/10.1093/europace/euac238
    • Leao, S., Luermans, J., Vernooy, K., ter Bekke, R., den Uijl, D., Linz, D., & Chaldoupi, S.-M. (2023). The great deceiver: a case series of 'double fire' atrioventricular nodal response. European Heart Journal - Case Reports, 7(4), Article ytad162. https://doi.org/10.1093/ehjcr/ytad162
    • Stoks, J., Hermans, B. M., Boukens, B. J. D., Holtackers, R. J., Gommers, S., Kaya, Y. S., Vernooy, K., Cluitmans, M. J. M., Volders, P. G. A., & ter Bekke, R. M. A. (2023). High-resolution structural-functional substrate-trigger characterization: Future roadmap for catheter ablation of ventricular tachycardia. Frontiers in Cardiovascular Medicine, 10(1), Article 1112980. https://doi.org/10.3389/fcvm.2023.1112980
  • 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, Article 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), Article 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), Article 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. https://doi.org/10.1093/eurheartj/ehab724.0326
    • 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, Article 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