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. 2019 Jun 25;9:9238. doi: 10.1038/s41598-019-45684-0

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Arrhythmogenic consequences of iCM engraftment onto the Purkinje system following transdifferentiation in a rabbit ventricular model. (a) Purkinje system with iCM engraftment onto a contiguous segment of the right bundle branch (RBB, white); 20 iCMs were coupled to a single Purkinje cell along the affected segment. Illustration of how collateral iCM engraftment onto the Purkinje could arise from transdifferentiation (inset). (b) RBB block occurred superior to the site of iCM engraftment when iCM-Purkinje junctional conductance was greater than 0.100 nS. Colors indicate time sequence of activation (ms) relative to simulated sinus beat. (c) Action potential traces obtained from RBB sites indicated in (a,b) for different values of iCM-Purkinje junctional conductance. All paced beats propagated through the RBB at 0.100 nS (left); 3:1 block and 2:1 block in the RBB was observed at junctional conductances of 1.000 (middle) and 8.000 nS (right), respectively.