BRIEF RESEARCH REPORT article
Front. Physiol.
Sec. Cardiac Electrophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1631426
This article is part of the Research TopicAdvancing Our Understanding of the Cardiac Conduction System to Prevent ArrhythmiasView all 3 articles
Functional conduction system mapping in sheep reveals Purkinje spikes in the free wall of the right ventricular outflow tract
Provisionally accepted
Michiel Blok1,2
Bram L. den Ouden3,4
Marion Kuiper5
Daan Ophelders6
Monique Jongbloed7
Stef Zeemering5Bjarke Jensen2
Arne van Hunnik5
Bastiaan J. Boukens3,5*- 1Anatomy & Embryology, Leiden University Medical Center (LUMC), Leiden, Netherlands
- 2Medical Biology, Amsterdam University Medical Center, Amsterdam, Netherlands
- 3Experimental Cardiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
- 4Microelectronics, Delft University of Technology, Delft, Netherlands
- 5Physiology, Maastricht University, Maastricht, Netherlands
- 6Pediatrics, Maastricht University, Maastricht, Netherlands
- 7Cardiology / Anatomy & Embryology, Leiden University Medical Center (LUMC), Leiden, Netherlands
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
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 40positive Purkinje fibers across and within the wall of the right ventricular outflow tract. Quantitative analysis showed 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.
Keywords: Right ventricular outflow tract, cardiac Purkinje system, cardiac arrhythmia, Cardiac Electrophysiology, Cardiac conduction system
Received: 19 May 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Blok, den Ouden, Kuiper, Ophelders, Jongbloed, Zeemering, Jensen, van Hunnik and Boukens. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bastiaan J. Boukens, Physiology, Maastricht University, Maastricht, Netherlands
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.