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His-Purkinje Involvement in Arrhythmias and Defibrillation

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Cardiac Bioelectric Therapy

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Abstract

The His–Purkinje system provides rapid and coordinated activation of the heart. In recent years, its role in the initiation and maintenance of ventricular arrhythmia has started to be explored. Experimentally, the Purkinje system (PS) has been shown to be an essential component to maintain long-duration ventricular fibrillation (more than 2 min) in humans and dogs, where computer models are able to show reentry mechanisms between the myocardium and the PS. Experiments and computer simulations have also shown that the PS may initiate ventricular fibrillation or ventricular tachycardia through early and delayed afterdepolarizations. In sum, arrhythmogenesis in the PS has been demonstrated and its implication is a current focus in research for rhythm control and prevention of cardiac sudden death.

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Acknowledgments

This work was supported in part by National Health Institutes, Heart, Lung, and Blood Institute Research Grants HL 128752 and grant support from the Treadwell Foundation.

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Authors and Affiliations

  1. The Nora Eccles Harrison Cardiovascular Research Training Institute, University of Utah, Salt Lake City, UT, USA

    Matthias Lange

  2. Division of Cardiothoracic Surgery, Department of Surgery and The Nora Eccles Harrison Cardiovascular Research Training Institute, University of Utah, Salt Lake City, UT, USA

    Derek J. Dosdall

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  1. Matthias Lange
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Correspondence to Derek J. Dosdall .

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Editors and Affiliations

  1. Department of Biomedical Engineering, The George Washington University, Washington, DC, USA

    Igor R. Efimov

  2. National Heart & Lung Institute, Imperial College London, London, UK

    Fu Siong Ng

  3. Philips EPD Solutions, Cambridge, MA, USA

    Jacob I. Laughner

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Lange, M., Dosdall, D.J. (2021). His-Purkinje Involvement in Arrhythmias and Defibrillation. In: Efimov, I.R., Ng, F.S., Laughner, J.I. (eds) Cardiac Bioelectric Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-63355-4_10

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