Visualization of left ventricular Purkinje fiber distribution using widefield optical coherence microscopy

Area of Science:

• Cardiovascular Research
• Cardiac Electrophysiology
• Medical Imaging

Background:

• Ventricular Purkinje fiber distribution is linked to idiopathic left ventricular arrhythmias.
• Anatomical variations impact catheter ablation success rates.
• Understanding Purkinje fiber anatomy is crucial for effective arrhythmia treatment.

Purpose of the Study:

• To visualize and characterize the distribution and connection of left ventricular Purkinje fibers in ovine hearts.
• To assess the utility of widefield high-speed, swept-source optical coherence microscopy (OCM) for Purkinje network imaging.
• To provide detailed anatomical insights for potential improvements in cardiac ablation procedures.

Main Methods:

• Utilized widefield OCM and light microscopy on incised ovine left ventricular walls.
• Observed Purkinje network distribution, direction, depth, and branching patterns without tissue destruction.
• Analyzed the Purkinje system from multiple tangential angles within a 4 × 4 mm² field of view.

Main Results:

• Characterized the ovine heart Purkinje network system using widefield OCM.
• Identified Purkinje fibers in the sub-endocardial area, traveling as wide hair bundles.
• Detailed the distal branching, multilayer connections, and direct links to papillary muscles and false tendons.

Conclusions:

• Widefield OCM successfully visualized the left bundle and its branching patterns in the ovine left ventricle non-destructively.
• The detailed Purkinje fiber mapping offers potential applications for future cardiac ablation procedures.
• This imaging technique provides valuable anatomical data for understanding and treating cardiac arrhythmias.