[Development, morphogenesis, and regeneration of cardiac Purkinje fibers]

Ventricular arrhythmias often originate in the Purkinje system, a network of specialized cardiomyocytes located on the luminal surface of the ventricles. The Purkinje system is part of the ventricular conduction system, which ensures the rapid propagation of electrical activity through the ventricles in order to synchronize their contractions. Although these cells represent only a tiny fraction of the ventricular mass, their pathogenic role is disproportionate. During embryogenesis, the ventricular conduction system arises from different populations of cardiac progenitors. Differentiation into fast-conducting cardiomyocytes occurs gradually as the ventricles develop, resulting in the formation of a single electrical circuit by the end of the fetal stage. This review highlights the structure-function relationship between the morphogenesis of the ventricular conduction system and conduction defects, and discusses recent data on the origin, development, and regeneration of the Purkinje fiber network.