Research Article Image-Based Structural Modeling of the Cardiac Purkinje Network

License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Purkinje network is a specialized conduction system within the heart that ensures the proper activation of the ventricles to produce effective contraction. Its role during ventricular arrhythmias is less clear, but some experimental studies have suggested that the Purkinje network may significantly affect the genesis and maintenance of ventricular arrhythmias. Despite its importance, few structuralmodels of the Purkinje network have been developed, primarily because current physical limitations prevent examination of the intact Purkinje network. In previousmodeling efforts Purkinje-like structures have been developed through either automated or hand-drawnprocedures, but these networks have been created according to general principles rather than based on real networks. To allow for greater realism in Purkinje structural models, we present a method for creating three-dimensional Purkinje networks based directly on imaging data. Our approach uses Purkinje network structures extracted from photographs of dissected ventricles and projects these flat networks onto realistic endocardial surfaces. Using thismethod, we createmodels for the combined ventricle-Purkinje system that can fully activate the ventricles through a stimulus delivered to the Purkinje network and can produce simulated activation sequences that match experimental observations. The combined models have the potential to help elucidate Purkinje network contributions during ventricular arrhythmias. 1