Intramural Purkinje fibers facilitate rapid ventricular activation in the equine heart

• Published in: Acta Physiologica Vol. 237; no. 3; pp. e13925 - n/a
• Main Authors: Elbrønd, Vibeke S., Thomsen, Morten B., Isaksen, Jonas L., Lunde, Ester D., Vincenti, Stefano, Wang, Tobias, Tranum‐Jensen, Jørgen, Calloe, Kirstine
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2023
• Subjects: Animals; conduction system; Connexin 43; ECG; EKG; Electrocardiography; Fibers; Heart; Heart Ventricles; horse; Horses; Mammals; mean electrical axis; Myocytes, Cardiac; Purkinje fiber; Purkinje fibers; Purkinje Fibers - physiology; Ventricle; horse; ECG; conduction system; Purkinje fiber; mean electrical axis
• ISSN: 1748-1708; 1748-1716
• DOI: 10.1111/apha.13925

Background The Purkinje fibers convey the electrical impulses at much higher speed than the working myocardial cells. Thus, the distribution of the Purkinje network is of paramount importance for the timing and coordination of ventricular activation. The Purkinje fibers are found in the subendocardium of all species of mammals, but some mammals also possess an intramural Purkinje fiber network that provides for relatively instantaneous, burst‐like activation of the entire ventricular wall, and gives rise to an rS configuration in lead II of the ECG. Aim To relate the topography of the horse heart and the distribution and histology of the conduction system to the pattern of ventricular activation as a mechanism for the unique electrical axis of the equine heart. Methods The morphology and distribution of the cardiac conduction system was determined by histochemistry. The electrical activity was measured using ECG in the Einthoven and orthogonal configuration. Results The long axis of the equine heart is close to vertical. Outside the nodal regions the conduction system consisted of Purkinje fibers connected by connexin 43 and long, slender parallel running transitional cells. The Purkinje fiber network extended deep into the ventricular walls. ECGs recorded in an orthogonal configuration revealed a mean electrical axis pointing in a cranial‐to‐left direction indicating ventricular activation in an apex‐to‐base direction. Conclusion The direction of the mean electrical axis in the equine heart is determined by the architecture of the intramural Purkinje network, rather than being a reflection of ventricular mass.