Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract

Ablation of sites displaying Purkinje activity is highly effective against idiopathic ventricular fibrillation which often originates in the right ventricular outflow tract. However, during endocardial mapping Purkinje potentials are rarely, if never, detected in the right ventricular outflow tract....

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Main Authors: Michiel Blok, Bram L. den Ouden, Marion Kuiper, Daan R. M. G. Ophelders, Monique R. M. Jongbloed, Stef Zeemering, Bjarke Jensen, Arne van Hunnik, Bastiaan J. Boukens
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2025.1631426/full
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author Michiel Blok
Michiel Blok
Bram L. den Ouden
Bram L. den Ouden
Marion Kuiper
Daan R. M. G. Ophelders
Daan R. M. G. Ophelders
Monique R. M. Jongbloed
Monique R. M. Jongbloed
Stef Zeemering
Bjarke Jensen
Arne van Hunnik
Bastiaan J. Boukens
Bastiaan J. Boukens
author_facet Michiel Blok
Michiel Blok
Bram L. den Ouden
Bram L. den Ouden
Marion Kuiper
Daan R. M. G. Ophelders
Daan R. M. G. Ophelders
Monique R. M. Jongbloed
Monique R. M. Jongbloed
Stef Zeemering
Bjarke Jensen
Arne van Hunnik
Bastiaan J. Boukens
Bastiaan J. Boukens
author_sort Michiel Blok
collection DOAJ
description Ablation of sites displaying Purkinje activity is highly effective against idiopathic ventricular fibrillation which often originates in the right ventricular outflow tract. However, during endocardial mapping Purkinje potentials are rarely, if never, detected in the right ventricular outflow tract. In the present study, we aimed to determine whether the Purkinje system extends into the right ventricular outflow tract. Hearts of five female sheep were blood-perfused in a Langendorff setup in which we performed epicardial and endocardial voltage mapping. During atrial pacing, the right ventricular outflow tract epicardium activated later than the epicardium of the left and right ventricular free walls. Endocardial mapping revealed Purkinje spikes at several sites in the free wall of the right ventricular outflow tract. In one heart, Purkinje spikes preceded ventricular premature beats during mapping, but were not visible during sinus rhythm. Subsequent immuno-histological examination showed a network of Connexin 40-positive Purkinje fibers across and within the wall of the right ventricular outflow tract. Quantitative analysis revealed that the transmural Purkinje fiber network was more abundant near the endocardium than epicardium. In conclusion, the Purkinje system extends into the right ventricular outflow tract of the sheep heart. These findings demonstrate that the sheep could be a valuable model for studying Purkinje-related arrhythmias in the right ventricular outflow tract.
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spelling doaj-art-64fc830ca72e4e1f85e8caaf98f050e62025-08-20T03:28:22ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-07-011610.3389/fphys.2025.16314261631426Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tractMichiel Blok0Michiel Blok1Bram L. den Ouden2Bram L. den Ouden3Marion Kuiper4Daan R. M. G. Ophelders5Daan R. M. G. Ophelders6Monique R. M. Jongbloed7Monique R. M. Jongbloed8Stef Zeemering9Bjarke Jensen10Arne van Hunnik11Bastiaan J. Boukens12Bastiaan J. Boukens13Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, NetherlandsLaboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Microelectronics, Delft University of Technology, Delft, NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, MosaKids Children’s Hospital, Maastricht, NetherlandsGROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, NetherlandsDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Cardiology, Centre for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Leiden University Medical Center, Leiden, NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, NetherlandsDepartment of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, location Academic Medical Center, Amsterdam, NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, NetherlandsLaboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, NetherlandsAblation of sites displaying Purkinje activity is highly effective against idiopathic ventricular fibrillation which often originates in the right ventricular outflow tract. However, during endocardial mapping Purkinje potentials are rarely, if never, detected in the right ventricular outflow tract. In the present study, we aimed to determine whether the Purkinje system extends into the right ventricular outflow tract. Hearts of five female sheep were blood-perfused in a Langendorff setup in which we performed epicardial and endocardial voltage mapping. During atrial pacing, the right ventricular outflow tract epicardium activated later than the epicardium of the left and right ventricular free walls. Endocardial mapping revealed Purkinje spikes at several sites in the free wall of the right ventricular outflow tract. In one heart, Purkinje spikes preceded ventricular premature beats during mapping, but were not visible during sinus rhythm. Subsequent immuno-histological examination showed a network of Connexin 40-positive Purkinje fibers across and within the wall of the right ventricular outflow tract. Quantitative analysis revealed that the transmural Purkinje fiber network was more abundant near the endocardium than epicardium. In conclusion, the Purkinje system extends into the right ventricular outflow tract of the sheep heart. These findings demonstrate that the sheep could be a valuable model for studying Purkinje-related arrhythmias in the right ventricular outflow tract.https://www.frontiersin.org/articles/10.3389/fphys.2025.1631426/fullright ventricular outflow tractcardiac Purkinje systemcardiac arrhythmiacardiac electrophysiologycardiac conduction system
spellingShingle Michiel Blok
Michiel Blok
Bram L. den Ouden
Bram L. den Ouden
Marion Kuiper
Daan R. M. G. Ophelders
Daan R. M. G. Ophelders
Monique R. M. Jongbloed
Monique R. M. Jongbloed
Stef Zeemering
Bjarke Jensen
Arne van Hunnik
Bastiaan J. Boukens
Bastiaan J. Boukens
Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
Frontiers in Physiology
right ventricular outflow tract
cardiac Purkinje system
cardiac arrhythmia
cardiac electrophysiology
cardiac conduction system
title Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
title_full Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
title_fullStr Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
title_full_unstemmed Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
title_short Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
title_sort functional conduction system mapping in sheep reveals purkinje spikes in the free wall of the right ventricular outflow tract
topic right ventricular outflow tract
cardiac Purkinje system
cardiac arrhythmia
cardiac electrophysiology
cardiac conduction system
url https://www.frontiersin.org/articles/10.3389/fphys.2025.1631426/full
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