Inward current of the rabbit sinoatrial node cell

Interval Type 2 Adaptive Neuro-Fuzzy Inference System-Based Artificial Pacemaker Design and Stability Analysis

This paper presents the design and simulation of an Interval type 2 fuzzy system (IT2FS) based, adaptive neuro-fuzzy inference system (ANFIS) pacemaker controller in MATLAB. After designing the type 1 fuzzy logic model, the stability of the designed system has been verified in the time-domain (unit step response). In previous works, the type 1 (IT1FS) model step response was analyzed. They are compared with the other proportional integral derivative (PID) and fuzzy models that only least-square-estimation and the backpropagation algorithms are used for tuning membership functions (MF) and generation of type 1 fis (fuzzy inference system) file. At current work, fuzzy C means (FCM) method shows better results than other methods have been used. The pacemaker controller determines the pacing rate and adjusts the heart rate of the patient for the reference input signal. The rise-time, overshoot and settling-time have been improved significantly.

Regulation of cardiac Ca(2+) channel by extracellular Na(+)

Hyponatremia is a predictor of poor cardiovascular outcomes during acute myocardial infarction and in the setting of preexisting heart failure [1]. There are no definitive mechanisms as to how hyponatremia suppresses cardiac function. In this report we provide evidence for direct down-regulation of Ca(2+) channel current in response to low serum Na(+). In voltage-clamped rat ventricular myocytes or HEK 293 cells expressing the L-type Ca(2+) channel, a 15mM drop in extracellular Na(+) suppressed the Ca(2+) current by ∼15%; with maximal suppression of ∼30% when Na(+) levels were reduced to 100mM or less. The suppressive effects of low Na(+) on I(Ca), in part, depended on the substituting monovalent species (Li(+), Cs(+), TEA(+)), but were independent of phosphorylation state of the channel and possible influx of Ca(2+) on Na(+)/Ca(2+) exchanger. Acidification sensitized the Ca(2+) channel current to Na(+) withdrawal. Collectively our data suggest that Na(+) and H(+) may interact with regulatory site(s) at the outer recesses of the Ca(2+) channel pore thereby directly modulating the electro-diffusion of the permeating divalents (Ca(2+), Ba(2+)).

Electrophysiology of islet cells

Stimulus-Secretion Coupling (SSC) of pancreatic islet cells comprises electrical activity. Changes of the membrane potential (V(m)) are regulated by metabolism-dependent alterations in ion channel activity. This coupling is best explored in beta-cells. The effect of glucose is directly linked to mitochondrial metabolism as the ATP/ADP ratio determines the open probability of ATP-sensitive K(+) channels (K(ATP) channels). Nucleotide sensitivity and concentration in the direct vicinity of the channels are controlled by several factors including phospholipids, fatty acids, and kinases, e.g., creatine and adenylate kinase. Closure of K(ATP) channels leads to depolarization of beta-cells via a yet unknown depolarizing current. Ca(2+) influx during action potentials (APs) results in an increase of the cytosolic Ca(2+) concentration ([Ca(2+)](c)) that triggers exocytosis. APs are elicited by the opening of voltage-dependent Na(+) and/or Ca(2+) channels and repolarized by voltage- and/or Ca(2+)-dependent K(+) channels. At a constant stimulatory glucose concentration APs are clustered in bursts that are interrupted by hyperpolarized interburst phases. Bursting electrical activity induces parallel fluctuations in [Ca(2+)](c) and insulin secretion. Bursts are terminated by I(Kslow) consisting of currents through Ca(2+)-dependent K(+) channels and K(ATP) channels. This review focuses on structure, characteristics, physiological function, and regulation of ion channels in beta-cells. Information about pharmacological drugs acting on K(ATP) channels, K(ATP) channelopathies, and influence of oxidative stress on K(ATP) channel function is provided. One focus is the outstanding significance of L-type Ca(2+) channels for insulin secretion. The role of less well characterized beta-cell channels including voltage-dependent Na(+) channels, volume sensitive anion channels (VSACs), transient receptor potential (TRP)-related channels, and hyperpolarization-activated cyclic nucleotide-gated (HCN) channels is discussed. A model of beta-cell oscillations provides insight in the interplay of the different channels to induce and maintain electrical activity. Regulation of beta-cell electrical activity by hormones and the autonomous nervous system is discussed. alpha- and delta-cells are also equipped with K(ATP) channels, voltage-dependent Na(+), K(+), and Ca(2+) channels. Yet the SSC of these cells is less clear and is not necessarily dependent on K(ATP) channel closure. Different ion channels of alpha- and delta-cells are introduced and SSC in alpha-cells is described in special respect of paracrine effects of insulin and GABA secreted from beta-cells.

Hyperpolarization-activated cyclic nucleotide-gated channels in pancreatic beta-cells

Hyperpolarization-activated cyclic nucleotide-modulated (HCN) channels mediate the pacemaker current (Ih or If) observed in electrically rhythmic cardiac and neuronal cells. Here we describe a hyperpolarization-activated time-dependent cationic current, beta-Ih, in pancreatic beta-cells. Transcripts for HCN1-4 were detected by RT-PCR and quantitative PCR in rat islets and MIN6 mouse insulinoma cells. beta-Ih in rat beta-cells and MIN6 cells displayed biophysical and pharmacological properties similar to those of HCN currents in cardiac and neuronal cells. Stimulation of cAMP production with forskolin/3-isobutyl-1-methylxanthine (50 microM) or dibutyryl-cAMP (1 mM) caused a significant rightward shift in the midpoint activation potential of beta-Ih, whereas expression of either specific small interfering (si)RNA against HCN2 (siHCN2b) or a dominant-negative HCN channel (HCN1-AAA) caused a near-complete inhibition of time-dependent beta-Ih. However, expression of siHCN2b in MIN6 cells had no affect on glucose-stimulated insulin secretion under normal or cAMP-stimulated conditions. Blocking beta-Ih in intact rat islets also did not affect membrane potential behavior at basal glucose concentrations. Taken together, our experiments provide the first evidence for functional expression of HCN channels in the pancreatic beta-cell.

An unexpected requirement for brain-type sodium channels for control of heart rate in the mouse sinoatrial node

Voltage-gated Na(+) channels are composed of pore-forming alpha and auxiliary beta subunits. The majority of Na(+) channels in the heart contain tetrodotoxin (TTX)-insensitive Na(v)1.5 alpha subunits, but TTX-sensitive brain-type Na(+) channel alpha subunits are present and functionally important in the transverse tubules of ventricular myocytes. Sinoatrial (SA) nodal cells were identified in cardiac tissue sections by staining for connexin 43 (which is expressed in atrial tissue but not in SA node), and Na(+) channel localization was analyzed by immunocytochemical staining with subtype-specific antibodies and confocal microscopy. Brain-type TTX-sensitive Na(v)1.1 and Na(v)1.3 alpha subunits and all four beta subunits were present in mouse SA node, but Na(v)1.5 alpha subunits were not. Na(v)1.1 alpha subunits were also present in rat SA node. Isolated mouse hearts were retrogradely perfused in a Langendorff preparation, and electrocardiograms were recorded. Spontaneous heart rate and cycle length were constant, and heart rate variability was small under control conditions. In contrast, in the presence of 100 nM TTX to block TTX-sensitive Na(+) channels specifically, we observed a significant reduction in spontaneous heart rate and markedly greater heart rate variability, similar to sick-sinus syndrome in man. We hypothesize that brain-type Na(+) channels are required because their more positive voltage dependence of inactivation allows them to function at the depolarized membrane potential of SA nodal cells. Our results demonstrate an important contribution of TTX-sensitive brain-type Na(+) channels to SA nodal automaticity in mouse heart and suggest that they may also contribute to SA nodal function and dysfunction in human heart.

Overdrive Excitation in the Guinea Pig Sinoatrial Node Superfused in High [K(+)](o)

The aim of the present experiments was to study the characteristics and mechanisms of the rhythm induced by overdrive ('overdrive excitation', ODE) in the sinoatrial node (SAN) superfused in high [K(+)](o) (8-14 mM). It was found that: (1) overdrive may induce excitation in quiescent SAN and during a slow drive; (2) in spontaneously active SAN, overdrive may accelerate the spontaneous discharge; (3) immediately after the end of overdrive, a pause generally precedes the onset of the induced rhythm; (4) during the pause, an oscillatory potential (V(os)) may be superimposed on the early diastolic depolarization (DD); (5) during the subsequent late DD, a different kind of oscillatory potential appears near the threshold for the upstroke (ThV(os)) which is responsible for the initiation of spontaneous activity; (6) once started, the induced rhythm is fastest soon after overdrive; (7) faster drives induce longer and faster spontaneous rhythms; (8) the induced action potentials are slow responses followed by DD with a superimposed V(os), but ThV(os) is responsible for ODE; (9) the induced rhythm subsides when ThV(os) miss the threshold and gradually decay; (10) low [Ca(2+)](o) abolishes ODE; (11) in quiescent SAN, high [Ca(2+)](o) induces spontaneous discharge through ThV(os) and increases its rate by enhancing V(os) and shifting the threshold to more negative values, and (12) tetrodotoxin abolishes ODE as welll as the spontaneous discharge induced by high [Ca(2+)](o). In conclusion, in K(+)-depolarized SAN, ODE may be present in the apparent absence of calcium overload, is Ca(2+)- and Na(+)-dependent and is mediated by ThV(os) and not by V(os). Copyright 1997 S. Karger AG, Basel

Electrical effects of okadaic acid extracted from black sponge on rabbit sinus node

1. Effects of okadaic acid on electrical responses and spontaneous activity in the dominant pacemaker cells of rabbit sinus node were investigated by use of microelectrode techniques. 2. Okadaic acid (10(-5) M to 4 x 10(-5) M) caused a shortening of cycle length of spontaneous firing (SPCL) accompanied by increases in both maximum upstroke velocity at phase 0 (Vmax) and amplitude of action potential. 3. All of the effects of okadaic acid were relatively well preserved in a low-Ca2+ medium (0.12 mM). Okadaic acid restored the spontaneous activity of sinus node pacemaker cells even in a Ca2(+)-deficient medium. 4. The effects of okadaic acid were markedly inhibited or abolished in a low Na+ medium (24 mM or 70 mM) and in the presence of a slow channel blocking agent, verapamil (10(-6) M). 5. In voltage-clamp experiments using a two-microelectrode technique, okadaic acid (10(-5) M) caused an increase in the slow inward current without affecting the outward current. At a higher concentration (4 x 10(-5) M), the drug increased the outward current. 6. These results indicate that okadaic acid causes an increase in spontaneous activity of sinus node pacemaker cells mediated by an enhancement of slow inward current (Isi) through verapamil-sensitive Ca2+ channels.

Modulation of an idioventricular rhythm by vagal tone

A 28 year old man with a stable permanent idioventricular rhythm of 80 to 85 beats/min, with all the characteristics of a pacemaker, is described. This pacemaker was slowed by maneuvers that enhanced vagal tone, including carotid sinus massage, the postrelease phase of the Valsalva maneuver and phenylephrine. The pacemaker was also slowed by a cholinesterase inhibitor (edrophonium hydrochloride) and accelerated by a muscarinic receptor blocking drug (hyoscine butylbromide). The actions of these maneuvers and agents were independent of sympathetic tone as propranolol pretreatment did not alter their effects. Similarly, propranolol did not affect the pacemaker rate. The pacemaker was not dependent on a slow inward current because verapamil did not affect its rate. The pacemaker accelerated in response to increased sympathetic tone induced by exercise and upright tilting and to the adrenergic agonist isoproterenol. The pacemaker was localized to the high posterior septal region of the left ventricle underneath the mitral valve. This report describes in a man an idioventicular pacemaker that is innervated by sympathetic and vagal fibers and responsive to alterations in tone of both limbs of the autonomic nervous system. It offers the first clear proof that a ventricular pacemaker can be innervated and controlled by the vagus nerve and provides its location.

The mammalian sinoatrial node

The sinoatrial node (SAN) was discovered in 1906 by Keith and Flack. The relation between its ultrastructure and function was first studied by Trautwein and Uchizono in 1963, whereas this relation was definitely established by Taylor and coworkers in 1978. The impulse originates from cells with a relatively low percentage of myofilaments. Earliest discharge is restricted to one site only in rabbit, guinea pig, cat, and pig and presumably also in larger animals. From this primary pacemaker area, the impulse is preferentially conducted towards the crista terminalis. The amount of cells in the primary pacemaker area may vary from a few hundred to a few thousand. In rabbit, guinea pig, cat, and pig, the amount of collagen is considerable. Normal SAN function was observed in the cat although the SAN volume occupied by myocytes was less than 5%. Changes in ionic composition of the perfusion fluid and the addition of autonomic substances may cause pacemaker shifts and altered activation patterns.

Properties of the hyperpolarizing-activated current (if) in cells isolated from the rabbit sino-atrial node

Individual cells were isolated from the sino-atrial node area of the rabbit heart using an enzyme medium containing collagenase and elastase. After enzymatic treatment the cells were placed in normal Tyrode solution, where beating resumed in a fraction of them. Isolated cells were studied in the whole cell configuration. Action potentials as well as membrane currents under voltage-clamp conditions were similar to those in multicellular preparations. Pulses to voltages more negative than about -50 mV caused activation of the hyperpolarizing-activated current, if. Investigation of the properties of this current was carried out under conditions that limited the influence of other current systems during voltage clamp. The if current activation range usually extended approximately from -50 to -100 mV, but varied from cell to cell. In several cases, pulsing to the region of -40 mV elicited a sizeable if. Both current activation and deactivation during voltage steps had S-shaped time courses. A high variability was however observed in the sigmoidal behaviour of if kinetics. Plots of the fully-activated current-voltage (I-V) relation in different extracellular Na and K concentrations showed that both ions carry the current if. While changes in the external Na concentration caused the current I-V relation to undergo simple shifts along the voltage axis, changes in extracellular K concentration were also associated with changes in its slope. Again, a large variability was observed in the increase of I-V slope on raising the external K concentration. The current if was strongly depressed by Cs, and the block induced by 5 mM-Cs was markedly voltage dependent. Adrenaline (1-5 microM) and noradrenaline (1 microM) increased the current if around the half-activation voltage range and accelerated its activation at more negative voltages. Often, however, drug application failed to elicit any modification of if. Current run-down was observed in nearly all cells, although at a highly variable rate. It was accelerated by raising the extracellular K concentration but did not show a marked use dependence. Both the if activation curve and the fully activated I-V relation were affected by run-down, the former being shifted to more negative values along the voltage axis and the latter being depressed with no apparent change of the if reversal potential.(ABSTRACT TRUNCATED AT 400 WORDS)

Electrophysiological effects of procaine in rabbit sino-atrial node cells

Effects of procaine (50-500 micrograms/ml) on membrane potential and currents were investigated using a two microelectrode-voltage clamp technique. Procaine reduced the action potential amplitude (APA), the maximum diastolic potential and the maximum rate of depolarization (Vmax) in a dose-dependent manner. At the same time, the action potential duration and the cycle length were prolonged. In voltage clamp experiments, procaine (50 micrograms/ml) did not affect the slow inward current (Isi), but reduced the time-dependent outward current (Ik). At concentrations higher than 100 micrograms/ml, procaine reduced both currents and the inward current activated by hyperpolarization in a dose-dependent manner. In 7 of 20 specimens, a low concentration of procaine (50 or 100 micrograms/ml) increased Isi which enhanced the Vmax and APA, but did not increase Ik. Procaine did not affect the steady-state inactivation of Isi (f infinity) and the activation of Ik (p infinity). The results suggest that the depressions of currents induced by procaine are due to a reduction in conductances of the current systems.

Slow inward current and cardiac arrhythmias

The slow inward current contributes to the normal electrical and contractile activity of several cardiac and vascular tissues and also may mediate the electrical abnormalities responsible for certain cardiac arrhythmias. The slow inward current differs from the fast inward sodium current in that it is carried primarily by calcium rather than sodium, requires a more positive level of membrane potential to be activated, has slower activation and inactivation kinetics, is responsible for normal depolarization in sinus and atrioventricular (AV) nodal cells and is blocked by a rather specific group of agents that includes verapamil, diltiazem and nifedipine. Recent data suggest that slow-channel openings occur in bursts, separated by silent periods, and that less negative membrane potentials and beta-adrenergic stimulation increase the probability that the channels will open. Inactivation of the channels is associated with a lower probability of channel opening. Slow-channel blocking agents such as verapamil, diltiazem and nifedipine appear to bind to activated, rather than rested, slow channels. Therefore, their effects are more prominent at faster pacing rates and at less negative membrane potentials. Clinically occurring cardiac arrhythmias dependent on the slow inward current include primarily sinus and AV nodal reentry and reciprocating tachycardia in the Wolff-Parkinson-White syndrome when one of the pathways incorporates the AV node. Damaged atrial, ventricular and specialized tissue also can generate slow response-mediated reentry or forms of automaticity that may be clinically important under certain circumstances.

Effect of alpha-dihydro-grayanotoxin-II on the electrical activity of the rabbit sino-atrial node

The effect of alpha-dihydro-grayanotoxin-II (GTX) on the electrical activity of rabbit sino-atrial (s.a.) node cells was studied by the two-micro-electrode voltage-clamp technique. GTX, at concentrations between 3 and 10 microM, suppressed the spontaneous beating of the s.a. node. On subsequent application of 1 microM-tetrodotoxin (TTX), the membrane repolarized and spontaneous beating was restored, whereas the maximum rate of rise and the frequency of the action potential were reduced slightly. The additional application of adrenaline (0.55 microM) (in the presence of GTX plus TTX) completely restored the normal electrical activity of the s.a. node cells. Voltage-clamp experiments revealed that GTX, in this concentration range, reduced the maximum conductance of slow inward current by 15%, and did not affect the outward current system. The steady-state inactivation curve for the slow inward current was not shifted along the membrane potential axis, whereas that for the fast inward Na current was shifted in the direction of hyperpolarization. In addition, GTX generated a time-independent current (IGTX) which could be eliminated by the application of TTX. The current-voltage relation for IGTX was linear and crossed the voltage axis at +4.0 +/- 2.2 mV (n = 4). The application of GTX in a concentration range above 30 microM abolished all gated inward and outward currents of the s.a. node. The results suggest that the GTX-induced sinus arrest is mainly due to an increase in the membrane permeability to Na ions and that this increase in permeability is due to conversion of the normal fast Na channel into a modified one, which lacks an inactivation process.

Isolation of calcium current and its sensitivity to monovalent cations in dialysed ventricular cells of guinea-pig

The ion selectivity of the Ca2+ channels in single ventricular cells of guinea-pig was studied using a 'giga-ohm seal' patch electrode for voltage clamp and internal dialysis. To isolate the Ca2+ channel current, currents through the Na+ channel and K+ channels were minimized by replacing external Na+ with Tris+ and removing K+ from both sides of the membrane. With 5 mM-ATP and 5 mM-EGTA in the pipette solution, the Ca2+ current was well maintained for more than 30 min in K+- and/or Na+-free external solution. Substitution of Cs+ for intracellular K+ eliminated the region of negative slope conductance in the steady-state current-voltage curve and shifted the zero-current potential or resting potential from -80 to -31 mV. After Cs+ substitution, a large inward current still flowed via inwardly rectifying K+ channels, but was abolished by removing external K+, which resulted in reduction of the resting membrane slope conductance to 1% of the control value. A decaying outward current attributable to the inwardly rectifying K+ channel was observed on depolarization in 5.4 mM-external K+ solution with Cs+-rich internal solution after blocking Ca2+ current. The induction of that current caused an apparent decrease of Ca2+ channel current when the K+-rich internal solution was switched to the Cs+-rich one at an external K+ concentration of 5.4 mM. When inwardly rectifying K+ current was suppressed by exposure to K+-free external solution, replacement of intracellular K+ with Cs+ caused no significant change in the Ca2+ current. With Cs+-rich solution in the electrode, the decaying outward current was responsible for an apparent depression of the Ca2+ current observed when extracellular K+ was increased. When the K+ current was abolished by 0.2 mM-extracellular Ba2+, changes in external K+ concentration did not affect the Ca2+ current, excluding the possibility of a direct inhibitory action of K+ on the Ca2+ channel. A time- and voltage-dependent outward current attributed to Cs+ was observed at potentials above +30 mV in Na+-, K+-free external solution with Cs+-rich internal solution. This current persisted in the presence of 20 mM-intracellular TEA Cl and 5 mM-extracellular 4-aminopyridine. Inorganic Ca2+ channel blockers, such as Co2+ or Cd2+, not only suppressed the inward Ca2+ current but also caused some reduction in outward current. Thus the blocker-sensitive peak current reversed at around +75 mV.(ABSTRACT TRUNCATED AT 400 WORDS)

Action potential and membrane currents of single pacemaker cells of the rabbit heart

Single, viable pacemaker cells were isolated from sinoatrial (S-A) and atrioventricular (A-V) nodes by treating with collagenase. In normal Tyrode solution containing 1.8 mM Ca2+, these pacemaker cells had a round configuration and contracted rhythmically at a frequency of about 150-260/min. The amplitude, duration, and maximum rate of rise of the spontaneous action potentials recorded using patch clamp electrodes were similar to those obtained from multicellular preparations. Amplitudes of the recorded membrane current were normalized with reference to the surface area of the cell by assuming the cell shape as a plane oblate spheroid. The membrane resistance of the isolated nodal cells was 14.9 +/- 4.0 k omega . cm2 (n = 12) at about -35 mV and the membrane capacitance was 1.30 +/- 0.24 microF/cm2 (n = 18). The inactivation time course of the slow inward current, isi, was fitted with a sum of two exponentials with time constants of 6.7 +/- 0.6 ms and 46.6 +/- 15.3 ms (n = 4) at +10 mV. The amplitude of isi peaked at 0 approximately +10 mV in the current-voltage relationship and was 18.2 +/- 8.4 microA/cm2. The potassium current, iK, was activated in the voltage range positive to -50 mV and was saturated at about +20 mV. The amplitude of the fully-activated iK at -40 mV was 3.3 +/- 1.4 microA/cm2 (n = 10) and showed an inward-going rectification. The activation of the hyperpolarization-activated current was observed at potentials negative to -70 mV in seven of 14 experiments. The current density and membrane capacitance calculated could be overestimated and the membrane resistance underestimated, because of the presence of caveolae on the cell surface. However, these data give the nearest possible estimates of the electrical constants in the nodal cells, which cannot be measured accurately in the conventional multicellular preparations.

Ionic currents responsible for the generation of pace-maker current in the rabbit sino-atrial node

The ionic nature of the pace-maker current (delta Ip, If, Ih) was investigated in rabbit sino-atrial node using a single sucrose-gap voltage-clamp technique. The pace-maker current was activated by hyperpolarizing clamp steps negative to -50 mV and the pace-maker potential was activated by an action potential or a depolarizing clamp step. Neither pace-maker current nor pace-maker potential were altered by addition of tetrodotoxin, but a tetrodotoxin-sensitive channel could be activated in sino-atrial nodal strips following hyperpolarizing clamp steps. Ca2+-channel blockers did not affect the voltage dependence of delta Ip or the maximum diastolic potential (m.d.p.) significantly. Removal of Ca2+ did not affect the pace-maker current at clamp potentials near the pace-maker potential range (-60 to -80 mV), but it did reduce the potential dependence of the m.d.p. Removal of Na+ suppressed completely the pace-maker current and hyperpolarized the membrane. Removal of Na+ also increased membrane conductance, most likely through an increase in resting K+ permeability. Low concentration of Cs+ (less than 5 mM), but not Ba2+ or tetraethylammonium, markedly suppressed activation delta Ip and reduced the rate of pacing slightly. Cs+ also decreased the membrane conductance and hyperpolarized the membrane. In 50% of experiments designed to determine contribution of IK to pace-maker current, a double-pulse procedure revealed a time-dependent component of delta Ip which reversed near the K+ equilibrium potential, EK. Release of depolarizing or hyperpolarizing test clamps was followed by pace-maker potentials, the magnitudes of which were dependent on the test-clamp potential. The m.d.p. approached values near EK following depolarizing clamps and near -45 mV following hyperpolarizing clamps. The results suggest that delta Ip is carried primarily by Na+ and is blocked by Cs+. It is likely, however, that Ca2+ alters the rate of pacing not only through its contribution to the Isi system, but also through activation of a K+ conductance.

Effects of amrinone on the transmembrane action potential of rabbit sinus node pacemaker cells

Effects of amrinone on the membrane action potential and spontaneous activity were investigated in sinus node pacemaker cells of rabbit heart by use of microelectrode techniques. Amrinone (1 X 10(-4) M to 6 X 10(-6) M) caused a shortening of cycle length of spontaneous firing (SPCL) accompanied by an increase in the maximum upstroke velocity at phase O (Vmax) and amplitude of action potential (AAP), while it did not affect the maximum diastolic potential (MDP). All the effects of amrinone on sinus node pacemaker cells were markedly attenuated or abolished in a low calcium medium (Ca+ 0.1 mM or 0.3 mM) or in the presence of the slow channel blocking agent, verapamil (5 X 10(-7) M, 2 X 10(-6) M). The effects of amrinone were not antagonized by the beta-adrenoceptor blocking agent, pindolol (2 X 10(-7) M). These results indicate that amrinone has an intrinsic effect on sinus node pacemaker cells, increasing their spontaneous firing activity. It is also assumed that the effects of amrinone on sinus node cells are probably mediated by an augmentation of the slow calcium and/or sodium inward current through the cell membrane.

Comparison of the direct effects of nifedipine and verapamil on the electrical activity of the sinoatrial and atrioventricular nodes of the rabbit heart

We compared the effects of nifedipine and verapamil on the rabbit sinus and atrioventricular nodes. Both drugs slowed the rate of impulse initiation by sinus node cells. Verapamil exerted a greater negative chronotropic effect at low concentrations, but at higher concentrations verapamil and nifedipine were equipotent. Nifedipine also reduced the amplitude of sinus node action potentials and the Vmax of phase O, effects which are identical to those previously described for verapamil. Both drugs slowed AV nodal conduction and prolonged refractory periods, but verapamil was more potent than nifedipine. Nifedipine reduced the amplitude of AV nodal action potentials and Vmax of phase O the same as verapamil. Nifedipine and verapamil, therefore, have nearly identical direct effects on the nodes. The failure of nifedipine to depress AV nodal conduction in situ and abolish reentrant AV nodal tachycardia is probably a result of the decreased sensitivity of the AV node to nifedipine compared to verapamil.

Interaction between calcium and slow channel blocking drugs on atrial rate

The relationship between extracellular calcium concentration and the chronotropic effect of prenylamine, verapamil and nifedipine was studied in isolated spontaneously beating rat atria. The three slow channel blocking drugs produced a concentration-dependent decrease in atrial rate, though with different relative potencies. The order of potency for decreasing atrial rate, independently of the calcium level (1.0, 3.0, 6.0 or 9.0 mmol/l) was: verapamil greater than nifedipine greater than prenylamine. Increasing calcium from 1.0 to 6.0 and 9.0 mmol/l increased atrial rate from 251 +/- beats . min-1 to 265 +/- 6 beats . min-1 and 285 +/- 9 beats . min-1 (mean +/- 1 standard error) respectively (P less than 0.05). Despite their positive chronotropic effect high calcium levels failed to reverse the negative chronotropic effect of the slow channel blockers. Furthermore, the negative chronotropic effect of both verapamil and nifedipine was enhanced at high calcium levels. Raising calcium from 1.0 to 6.0 mmol/l in the presence of verapamil (1 X 10(-7) mol/l) or nifedipine (3 X 10(-7) mol/l) increased 2-fold the negative chronotropic effect of the calcium channel blockers. In addition, the concentration-effect curves for verapamil and nifedipine shifted to the left by 0.50 +/- 0.14 and 0.50 +/- 0.16 log units, respectively, when calcium increased from 1.0 to 6.0 mmol/l. The data show that increasing calcium may produce positive or negative chronotropic effects depending on whether or not the calcium channels are blocked. This paradoxical effect of calcium ions can be produced either by opposite chronotropic effects on automatic cells or by shifting the pacemaker activity to a group of cells which respond in a different way to an increment of calcium.

Effects of barium on the membrane currents in the rabbit S-A node

In small preparations of rabbit sinoatrial node voltage clamp experiments with the two microelectrode technique were carried out. The effects of extracellular barium ions on the slow inward current and outward currents were studied and the following results were obtained: 1. Ba increased the amplitude of the slow inward current without a change in the time course of inactivation. In 10 mM Ba the steady-state inactivation curve (f infinity) shifted in the positive direction (3-4 mV), suggesting a neutralization of negative surface charges. A similar shift of the steady state activation curve (d infinity) could not be detected. 2. Ba reduced the amplitude of the time-dependent (IK, Ix) and time-independent (Ibg) potassium currents in a concentration-dependent manner. 3. The block of the time-dependent potassium current, IK, depended on the membrane potential. The block was stronger at negative than at positive potentials. The block could be relieved by depolarizing pulses, the degree of unblock increased with longer duration of the depolarizing pulse. 4. Ba blocked the slow outward current Ix in a voltage- and time-dependent manner. Like for IK, the block of Ix was stronger at negative than at positive potentials. A given concentration of Ba produced stronger block of Ix than of IK and the removal of block of Ix by depolarizing pulses was slower than the removal of IK block. 5. The effects of Ba on Ix suggest that this current is a potassium current.

Membrane currents in the rabbit atrioventricular node cell

The rabbit A-V node was dissected into pieces (0.2 x 0.2 x 0.2 mm) smaller than its space constant of 692 +/- 96 micrometers (n = 5). These small specimens showed spontaneous action potentials whose configurations were similar to those of large specimens before dissection. The membrane time constant was 21.5 +/- 1.5 ms (n = 5). Voltage clamp experiments were performed on the above specimens using the two-microelectrode technique. On depolarization from the holding potential of -40 mV to various potential levels a transient inward current and delayed outward current were recorded. On repolarization an outward current tail was observed. The transient inward current was blocked by application of D 600 (2 x 10(-7) g/ml) but was insensitive to TTX (1 x 10(-7) g/ml). The inward current was decreased by superfusion with Na- or Ca-free Tyrode solution. Thus, this current was classified as the slow inward current (is). When the K concentration in the Tyrode solution was varied, the reversal potential of the outward current tail changed as expected for a K electrode, indicating that the outward current was carried by K ions. On hyperpolarization slow activation of inward current was recorded. The reversal potential of this current was between -20 and -30 mV, which was analogous to hyperpolarization activated current, ih, in the S-A node. A contribution of sodium current (iNa) to the action potential was obviously demonstrated from an inhibitory effect of TTX on the upstroke of the anodal break excitation. The ionic selectivity of each current system is compared with analogous current systems in other cardiac tissues and a possible mechanism for the slow conduction in the A-V node is discussed.

Effects of calcium and sodium concentrations on atrioventricular conduction: experimental study in rabbit hearts with clinical implications on heart block and slow calcium channel blocking agent usage

Effects of electrolyte concentrations on atrioventricular (AV) conduction were studied in isolated, perfused rabbit hearts by recording the His bundle electrogram. Initial calcium (Ca++), sodium (Na+), and potassium (K+) concentrations were 2.4, 144.8, and 4.5 mM, respectively. Lowering of Ca++ to 0.8 mM slightly prolonged the AH interval, whereas elevation of Ca++ to 4.8 or 7.2 mM more markedly prolonged this interval, often causing intranodal block. High Ca++-induced depression of intranodal conduction was antagonized by high K+ (7.5 mM). Verapamil (0.5 to 1.0 mg/L) produced second-degree intranodal block. High Na+ (172 mM) restored 1:1 conduction, whereas high Ca++ did not. These results suggest that: (1) an optimal Ca++ concentration for intranodal conduction exists; (2) high K+ counteracts high Ca++-induced intranodal block; (3) verapamil effect on AV node is antagonized by high Na+; and (4) slow Na+ current may play a role in AV nodal action potentials.

Parameters affecting the slow inward channel repriming process in frog atrium

1. The time of recovery (from the inactivation) of the slow inward current was studied in the frog atrium, using the double sucrose gap voltage clamp technique. 2. The 'repriming' process was found to be distinct from the current inactivation, and to depend on experimental protocol: double pulses given at low frequencies (at 'rest') gave a faster recovery time when compared to recovery during constant stimulation, with interposed stimuli monitoring the recovery. Longer durations of the clamp pulses led to a faster recovery process. 3. Changing the holding potential of the membrane (with double pulses to the same absolute membrane potential monitoring the recovery process) greatly affect the repriming with depolarized levels slowing down the process. 4. The recovery time was fastest following clamp pulses to intermediate membrane potentials (in the plateau range). This was determined by double pulses, from a constant hold potentials, to different levels. 5. Decreasing extracellular Ca prolonged, and increasing Ca enhanced the recovery process. 6. The recovery process was markedly slowed down in Na or in K-free solutions. 7. The recovery process was enhanced in solutions with a raised concentration of Mg or H ions (lower pH). In higher Mg solutions, the inactivation of the slow inward current was slower. 8. It is proposed that the recovery process is sensitive to alterations in intracellular Ca ions and to variations in extracellular surface charges. The possible implications are discussed.

Potassium current during the pacemaker depolarization in rabbit sinoatrial node cell

Voltage clamp experiments were carried out on the rabbit sinoatrial (S-A) node. The delayed outward current in the voltage range between --60 mV and --22 mV almost disappeared in the presence of 5 mM Ba2+. The slow inward current and the hyperpolarization-activated current remained unaffected. In the absence of the time-dependent potassium current the S-A node cell generated spontaneous action potentials, provided that the membrane was hyperpolarized by constant outward current. Therefore it seems unlikely that the potassium current plays an essential role in generating the pacemaker potential in the S-A node. The time course of the potassium current (iK) during the cardiac cycle was calculated using equations simulating the kinetics of iK. According to this computation, the change of iK in the S-A node is small during pacemaker depolarization. It is proposed that the gradual decay of potassium conductance is less important for the development of the pacemaker potential than the contribution of the slow inward current.

The influence of hypoxia and metabolic inhibitors on the excitation process in atrioventricular node

In small specimens prepared from the atrioventricular node of rabbits, the influence of hypoxia and metabolic inhibitors (Na-cyanide, 2.4 dinitrophenol, 2-desoxyglucose) on the av-node action potential was studied. The action potentials in these specimens proved to be of slow response type regardless of their origin, either the N or the NH-region of the node. 1. Following superfusion with O2-poor Tyrode solution, Vmax of the atrioventricular action potential gradually declined within 90 min and attained finally a new steady state. A mean decrease of 30.2 +/- 9.4% was obtained. Frequency a automatic impulse formation went down by almost the same amount within only 20 min. On return to an oxygenated Tyrode solution, or in the continued presence of O2 deficiency after an increase of the external glucose concentration from 11 mM to 33 mM, full recovery of these effects occurred. 2. After administration of Na-cyanide (1 X 10(-3) M), a similar Vmax decrease of 29.0 +/- 7.0% appeared. It took only 20 min for full development and was accompanied by a decrease reversible within 10-20 min on return to a cyanide-free medium. Poisoning the atrioventricular cell with 2.4 dinitrophenol (1 X 10(-3) M) led to the same result. Treatment with 2-desoxyglucose (3 X 10(-2) M) evoked a more pronounced Vmax diminution of 50%. 3. The inhibitor of K conductance, 4-aminopyridine (2 X 10(-3) M) did not remove the metabolically induced changes of Vmax of the atrioventricular action potential. After poisoning of oxydative phosphorylation, this compound caused in some cases evan a further reduction of Vmax. 4. The beta-adrenergic compound isoproterenol (9.2 X 10(-6) M) restored the hypoxia or cyanide-induced suppression of both Vmax and frequency of automatic impulse formation. The particularly pronounced response of Vmax led to an increase far exceeding the initial control values obtained under normal metabolic conditions of the atrioventricular cell.

Slow inward current and its role mediating the chronotropic effect of epinephrine in the rabbit sinoatrial node

The ionic mechanism underlying the chronotropic effect of epinephrine on the rabbit sinoatrial (S-A) node has been studied. Epinephrine (5.5 X 10(-6) M) increased the spontaneous rate from 206 +/- 25 min-1 to 242 +/- 39 min-1. The effect of epinephrine was reproducible on repetitive applications. Voltage clamp experiments using the two microelectrode technique revealed the following changes in the membrane current: epinephrine (5.5 X 10(-7) M) increased the limiting conductance for the slow inward current (is) by approximately 30% and the potassium current (ik) by about 10%, keeping the kinetics of is and ik constant. From the holding potential of -70 mV the activation of is was observed on step depolarization positive to -60 or -55 mV in both control and epinephrine solution. The hyperpolarization-activated current (ih) was also increased by about 20% at -70 mV, and its time course was slightly accelerated. Participation of is for the chronotropic effect of epinephrine was strongly suggested by the findings that is was partially available positive to -60 mV and that epinephrine could not increase the slope of diastolic depolarization when is was blocked by D 600.

Inward current activated during hyperpolarization in the rabbit sinoatrial node cell

Inward current activated by hyperpolarization (ih) was dissected from the K-current by the difference in its activation voltage range and the selective blocking effect of Ba2+ on the K-current. The ih shows little specificity to any particular ion, and its reversal potential was -25 mV. The current system can be expressed well by Hodgkin-Huxley type kinetics. The time constant of ih ranged from 2-4 s at about -70 mV, but it became shorter at about -10 mV. The ih began to activate at -50 mV and fully saturated at about -100 mV. The fully activated current-voltage relation shows no rectifying property. Activation and deactivation time courses were fitted by a single exponential with the same time constant at a given membrane potential. Although ih plays only a small role during the normal action potential in the isolated preparation, it plays a significant role in keeping the pacemaker cell at a low membrane potential

Voltage-clamp investigations of membrane currents underlying pace-maker activity in rabbit sino-atrial node

1. Small preparations of spontaneously beating rabbit sino-atrial node have been investigated using the two micro-electrode voltage-clamp technique. 2. Hyperpolarizing clamp pulses given from holding potentials of about -45 mV reveal a time-dependent change of a membrane current, if, which is shown to overlap the pace-maker range (-65 mV to -45 mV) for these preparations. 3. The changes in if are shown to be quite distinct from the de-activation of the time-dependent outward current, iK. 4. The time-dependent changes of the if system increase during adrenaline application and therefore contribute to the chronotropic action of adrenaline on the heart. 5. Evidence for a link between slow inward current (iSi) and time-dependent outward current (iK) in rabbit sino-atrial node is presented and assessed.