The role of Purkinje-myocardial coupling during ventricular arrhythmia: a modeling study

The Purkinje system is the fast conduction network of the heart which couples to the myocardium at discrete sites called Purkinje-Myocyte Junctions (PMJs). However, the distribution and number of PMJs remains elusive, as does whether a particular PMJ is functional. We hypothesized that the Purkinje...

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Bibliographic Details
Published in:PloS one 2014-02, Vol.9 (2), p.e88000-e88000
Main Authors: Behradfar, Elham, Nygren, Anders, Vigmond, Edward J
Format: Article
Language:English
Subjects:
Action Potentials - physiology
Analysis
Animals
Arrhythmia
Biology
Cardiac arrhythmia
Cardiomyopathy
Computer engineering
Computer Science
Computer Simulation
Conduction
Density
Dynamics
Electrical junctions
Engineering
Epicardium
Finite element method
Firing rate
Fractals
Heart
Heart - physiopathology
Ischemia
Medicine
Models, Cardiovascular
Myocardium
Physiology
Propagation
Purkinje Fibers - physiopathology
Rabbits
Reentry
Singularities
Topology
Ventricle
Ventricular Fibrillation - physiopathology
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Summary:The Purkinje system is the fast conduction network of the heart which couples to the myocardium at discrete sites called Purkinje-Myocyte Junctions (PMJs). However, the distribution and number of PMJs remains elusive, as does whether a particular PMJ is functional. We hypothesized that the Purkinje system plays a role during reentry and that the number of functional PMJs affect reentry dynamics. We used a computer finite element model of rabbit ventricles in which we varied the number of PMJs. Sustained, complex reentry was induced by applying an electric shock and the role of the Purkinje system in maintaining the arrhythmia was assessed by analyzing phase singularities, frequency of activation, and bidirectional propagation at PMJs. For larger junctional resistances, increasing PMJ density increased the mean firing rate in the Purkinje system, the percentage of successful retrograde conduction at PMJs, and the incidence of wave break on the epicardium. However, the mean firing of the ventricles was not affected. Furthermore, increasing PMJ density above 13/[Formula: see text] did not alter reentry dynamics. For lower junctional resistances, the trend was not as clear. We conclude that Purkinje system topology affects reentry dynamics and conditions which alter PMJ density can alter reentry dynamics.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0088000