Purkinje fibres are large, specialised cardiac muscle cells that form a network beneath the endocardium of both ventricles. They conduct electricity faster than any other cardiac tissue, at about 2-4 metres per second. Through them, the impulse reaches almost the whole inner ventricular wall nearly at once.
| Location | Subendocardial network lining the inner surfaces of both ventricles, including the papillary muscles, fed by the terminal branches of the bundle branches. |
|---|---|
| Parts |
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Distribute the electrical impulse rapidly throughout the ventricular walls so that contraction starts at the apex and spreads upwards, squeezing blood towards the outflow valves. They can act as a slow backup pacemaker (about 20-40 beats per minute) if higher sites fail.
Purkinje fibres are a frequent source of the premature beats that trigger ventricular fibrillation, and targeting them by ablation can help some patients with recurrent episodes. They are relatively resistant to ischaemia because they sit close to the oxygenated blood in the chambers. The term 'cardiac conduction muscle' covers the whole specialised system of which they are the final part.
Extra beats arising in the ventricles, sometimes from Purkinje tissue. They are often harmless but can trigger dangerous arrhythmias in a diseased heart.
Chaotic ventricular electrical activity with no effective pumping, causing cardiac arrest. Survival depends on immediate CPR and defibrillation.
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