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Nayak AR, Panfilov AV, Pandit R. Spiral-wave dynamics in a mathematical model of human ventricular tissue with myocytes and Purkinje fibers. Phys Rev E 2017; 95:022405. [PMID: 28297843 DOI: 10.1103/physreve.95.022405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Indexed: 06/06/2023]
Abstract
We present systematic numerical studies of the possible effects of the coupling of human endocardial and Purkinje cells at cellular and two-dimensional tissue levels. We find that the autorhythmic-activity frequency of the Purkinje cell in a composite decreases with an increase in the coupling strength; this can even eliminate the autorhythmicity. We observe a delay between the beginning of the action potentials of endocardial and Purkinje cells in a composite; such a delay increases as we decrease the diffusive coupling, and eventually a failure of transmission occurs. An increase in the diffusive coupling decreases the slope of the action-potential-duration-restitution curve of an endocardial cell in a composite. By using a minimal model for the Purkinje network, in which we have a two-dimensional, bilayer tissue, with a layer of Purkinje cells on top of a layer of endocardial cells, we can stabilize spiral-wave turbulence; however, for a sparse distribution of Purkinje-ventricular junctions, at which these two layers are coupled, we can also obtain additional focal activity and many complex transient regimes. We also present additional effects resulting from the coupling of Purkinje and endocardial layers and discuss the relation of our results to the studies performed in anatomically accurate models of the Purkinje network.
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Affiliation(s)
- Alok Ranjan Nayak
- International Institute of Information Technology (IIIT-Bhubaneswar), Gothapatna, Po: Malipada, Bhubaneswar 751003, India
| | - A V Panfilov
- Department of Physics and Astronomy, Gent University, Krijgslaan 281, S9, 9000 Gent, Belgium
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia
| | - Rahul Pandit
- Centre for Condensed Matter Theory, Department of Physics, Indian Institute of Science, Bangalore 560012, India
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Purkinje Cells as Sources of Arrhythmias in Long QT Syndrome Type 3. Sci Rep 2015; 5:13287. [PMID: 26289036 PMCID: PMC4542521 DOI: 10.1038/srep13287] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/16/2015] [Indexed: 12/27/2022] Open
Abstract
Long QT syndrome (LQTS) is characterized by ventricular arrhythmias and sudden cardiac death. Purkinje cells (PC) within the specialized cardiac conduction system have unique electrophysiological properties that we hypothesize may produce the primary sources of arrhythmia in heritable LQTS. LQTS type 3 (LQT3) transgenic mice harboring the ΔKPQ+/− mutation were crossed with Contactin2-EGFP BAC transgenic mice, which express a fluorescent reporter gene within the Purkinje fiber network. Isolated ventricular myocytes (VMs) (EGFP−) and PCs (EGFP+) from wild type and ΔKPQ mutant hearts were compared using the whole-cell patch clamp technique and microfluorimetry of calcium transients. Increased late sodium current was seen in ΔKPQ-PCs and ΔKPQ-VMs, with larger density in ΔKPQ-PCs. Marked prolongation of action potential duration of ΔKPQ-PCs was seen compared to ΔKPQ-VMs. ΔKPQ-PCs, but not ΔKPQ-VMs, exhibited frequent early afterdepolarizations, which corresponded to repetitive oscillations of intracellular calcium. Abnormalities in cell repolarization were reversed with exposure to mexiletine. We present the first direct experimental evidence that PCs are uniquely sensitive to LQT3 mutations, displaying electrophysiological behavior that is highly pro-arrhythmic.
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Angel N, Li L, Dosdall DJ. His bundle activates faster than ventricular myocardium during prolonged ventricular fibrillation. PLoS One 2014; 9:e101666. [PMID: 25036418 PMCID: PMC4103805 DOI: 10.1371/journal.pone.0101666] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/09/2014] [Indexed: 11/30/2022] Open
Abstract
Background The Purkinje fiber system has recently been implicated as an important driver of the rapid activation rate during long duration ventricular fibrillation (VF>2 minutes). The goal of this study is to determine whether this activity propagates to or occurs in the proximal specialized conduction system during VF as well. Methods and Results An 8×8 array with 300 µm spaced electrodes was placed over the His bundles of isolated, perfused rabbit hearts (n = 12). Ventricular myocardial (VM) and His activations were differentiated by calculating Laplacian recordings from unipolar signals. Activation rates of the VM and His bundle were compared and the His bundle conduction velocity was measured during perfused VF followed by 8 minutes of unperfused VF. During perfused VF the average VM activation rate of 11.04 activations/sec was significantly higher than the His bundle activation rate of 6.88 activations/sec (p<0.05). However from 3–8 minutes of unperfused VF the His system activation rate (6.16, 5.53, 5.14, 5.22, 6.00, and 4.62 activations/sec significantly faster than the rate of the VM (4.67, 3.63, 2.94, 2.24, 3.45, and 2.31 activations/sec) (p<0.05). The conduction velocity of the His system immediately decreased to 94% of the sinus rate during perfused VF then gradually decreased to 67% of sinus rhythm conduction at 8 minutes of unperfused VF. Conclusion During prolonged VF the activation rate of the His bundle is faster than that of the VM. This suggests that the proximal conduction system, like the distal Purkinje system, may be an important driver during long duration VF and may be a target for interventional therapy.
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Affiliation(s)
- Nathan Angel
- Comprehensive Arrhythmia Research & Management Center, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, United States of America
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States of America
| | - Li Li
- Comprehensive Arrhythmia Research & Management Center, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Derek J. Dosdall
- Comprehensive Arrhythmia Research & Management Center, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, United States of America
- Department of Bioengineering, University of Utah, Salt Lake City, UT, United States of America
- Center for Engineering Innovation, University of Utah, Salt Lake City, UT, United States of America
- * E-mail:
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Walton RD, Martinez ME, Bishop MJ, Hocini M, Haïssaguerre M, Plank G, Bernus O, Vigmond EJ. Influence of the Purkinje-muscle junction on transmural repolarization heterogeneity. Cardiovasc Res 2014; 103:629-40. [PMID: 24997066 DOI: 10.1093/cvr/cvu165] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To elucidate the properties of the PMJ and myocardium underlying these effects. Transmural heterogeneity of action potential duration (APD) is known to play an important role in arrhythmogenesis. Regions of non-uniformities of APD gradients often overlap considerably with the location of Purkinje-muscle junctions (PMJs). We therefore hypothesized that such junctions are novel sources of local endocardial and transmural heterogeneity of repolarization, and that remodelling due to heart failure modulates this response. METHODS AND RESULTS Spatial gradients of endocardial APD in left ventricular wedge preparations from healthy sheep (n = 5) were correlated with locations of PMJs identified through Purkinje stimulation under optical mapping. APD prolongation was dependent on proximity of the PMJ to the imaged surface, whereby shallow PMJs significantly modulated local APD when stimulating either Purkinje (P = 0.0116) or endocardium (P = 0.0123). In addition, we model a PMJ in 5 × 5× 10 mm transmural tissue wedges using healthy and novel failing human ventricular and Purkinje ionic models. Short distances of the PMJ to cut surfaces (<0.875 mm) revealed that APD maxima were localized to the PMJ in healthy myocardium, whereas APD minima were observed in failing myocardium. Amplitudes and spatial gradients of APD were prominent at functional PMJs and quiescent PMJs. Furthermore, increasing the extent of Purkinje fibre branching or decreasing tissue conductivity augmented local APD prolongation in both failing and non-failing models. CONCLUSIONS The Purkinje network has the potential to influence myocardial AP morphology and rate-dependent behaviour, and furthermore to underlie enhanced transmural APD heterogeneities and spatial gradients of APD in non-failing and failing myocardium.
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Affiliation(s)
- Richard D Walton
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, Bordeaux, France Inserm U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France
| | - Marine E Martinez
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, Bordeaux, France Inserm U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France
| | - Martin J Bishop
- Biomedical Engineering Department, Division of Imaging Sciences, King's College London, London, UK
| | - Mélèze Hocini
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, Bordeaux, France Inserm U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France CHU de Bordeaux, Hôpital du Haut lévêque, Pessac, France
| | - Michel Haïssaguerre
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, Bordeaux, France Inserm U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France CHU de Bordeaux, Hôpital du Haut lévêque, Pessac, France
| | - Gernot Plank
- Institute of Biophysics, Medical University of Graz, Graz, Austria
| | - Olivier Bernus
- Université de Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux U1045, Bordeaux, France Inserm U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Bordeaux, France L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France
| | - Edward J Vigmond
- L'Institut de Rythmologie et Modélisation Cardiaque LIRYC, Université de Bordeaux, CRCTB U1045, PTIB - Campus Xavier Arnozan, Avenue du Haut Lévêque, 33600 Bordeaux, France L'Institut de Mathématiques de Bordeaux UMR 5251, Université de Bordeaux, Bordeaux, France Department of Electrical and Computer Engineering, University of Calgary, Calgary, Canada
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Nguyen TP, Qu Z, Weiss JN. Cardiac fibrosis and arrhythmogenesis: the road to repair is paved with perils. J Mol Cell Cardiol 2013; 70:83-91. [PMID: 24184999 DOI: 10.1016/j.yjmcc.2013.10.018] [Citation(s) in RCA: 215] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/12/2013] [Accepted: 10/22/2013] [Indexed: 01/02/2023]
Abstract
In the healthy heart, cardiac myocytes form an electrical syncytium embedded in a supportive fibroblast-rich extracellular matrix designed to optimize the electromechanical coupling for maximal contractile efficiency of the heart. In the injured heart, however, fibroblasts are activated and differentiate into myofibroblasts that proliferate and generate fibrosis as a component of the wound-healing response. This review discusses how fibroblasts and fibrosis, while essential for maintaining the structural integrity of the heart wall after injury, have undesirable electrophysiological effects by disrupting the normal electrical connectivity of cardiac tissue to increase the vulnerability to arrhythmias. We emphasize the dual contribution of fibrosis in altering source-sink relationships to create a vulnerable substrate while simultaneously facilitating the emergence of triggers such as afterdepolarization-induced premature ventricular complexes-both factors combining synergistically to promote initiation of reentry. We also discuss the potential role of fibroblasts and myofibroblasts in directly altering myocyte electrophysiology in a pro-arrhythmic fashion. Insight into these processes may open up novel therapeutic strategies for preventing and treating arrhythmias in the setting of heart disease as well as avoiding potential arrhythmogenic consequences of cell-based cardiac regeneration therapy. This article is part of a Special Issue entitled "Myocyte-Fibroblast Signaling in Myocardium."
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Affiliation(s)
- Thao P Nguyen
- UCLA Cardiovascular Research Laboratory and the Departments of Medicine (Division of Cardiology) and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Zhilin Qu
- UCLA Cardiovascular Research Laboratory and the Departments of Medicine (Division of Cardiology) and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - James N Weiss
- UCLA Cardiovascular Research Laboratory and the Departments of Medicine (Division of Cardiology) and Physiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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6
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Aslanidi OV, Sleiman RN, Boyett MR, Hancox JC, Zhang H. Ionic mechanisms for electrical heterogeneity between rabbit Purkinje fiber and ventricular cells. Biophys J 2010; 98:2420-31. [PMID: 20513385 DOI: 10.1016/j.bpj.2010.02.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/14/2010] [Accepted: 02/12/2010] [Indexed: 10/19/2022] Open
Abstract
The intrinsic heterogeneity of electrical action potential (AP) properties between Purkinje fibers (PFs) and the ventricular wall, as well as within the wall, plays an important role in ensuring successful excitation of the ventricles. It can also be proarrhythmic due to nonuniform repolarization across the Purkinje-ventricular junction. However, the ionic mechanisms that underlie the marked AP differences between PFs and ventricular cells are not fully characterized. We studied such mechanisms by developing a new family of biophysically detailed AP models for rabbit PF cells and three transmural ventricular cell types. The models were based on and validated against experimental data recorded from rabbit at ionic channel, single cell, and tissue levels. They were then used to determine the functional roles of each individual ionic channel current in modulating the AP heterogeneity at the rabbit Purkinje-ventricular junction, and to identify specific currents responsible for the differential response of PFs and ventricular cells to pharmacological interventions.
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Affiliation(s)
- Oleg V Aslanidi
- Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, United Kingdom
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7
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Goaillard JM, Marder E. Dynamic clamp analyses of cardiac, endocrine, and neural function. Physiology (Bethesda) 2007; 21:197-207. [PMID: 16714478 DOI: 10.1152/physiol.00063.2005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The dynamic clamp introduces artificial conductances into cells to simulate electrical coupling, votage-dependent, leak, and synaptic conductances. This review describes how the dynamic clamp has been used to address various questions in the cardiac, endocrine, and nervous systems.
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Affiliation(s)
- Jean-Marc Goaillard
- Volen Center and Biology Department, Brandeis University, Waltham, Massachusetts, USA
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8
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Abstract
Dynamic clamp is a collection of closely related techniques that have been employed in cardiac electrophysiology to provide direct answers to numerous research questions regarding basic cellular mechanisms of action potential formation, action potential transfer and action potential synchronization in health and disease. Building on traditional current clamp, dynamic clamp was initially used to create virtual gap junctions between isolated myocytes. More recent applications include the embedding of a real pacemaking myocyte in a simulated network of atrial or ventricular cells and the insertion of virtual ion channels, either simulated in real time or simultaneously recorded from an expression system, into the membrane of an isolated myocyte. These applications have proven that dynamic clamp, which is characterized by the real-time evaluation and injection of simulated membrane current, is a powerful tool in cardiac electrophysiology. Here, each of the three different experimental configurations used in cardiac electrophysiology is reviewed. Also, directions are given for the implementation of dynamic clamp in the cardiac electrophysiology laboratory. With the growing interest in the application of dynamic clamp in cardiac electrophysiology, it is anticipated that dynamic clamp will also prove to be a powerful tool in basic research on biological pacemakers and in identification of specific ion channels as targets for drug development.
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Affiliation(s)
- Ronald Wilders
- Department of Physiology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
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9
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Hongo D, Bryson JS, Kaplan AM, Cohen DA. Endogenous Nitric Oxide Protects against T Cell-Dependent Lethality during Graft-versus-Host Disease and Idiopathic Pneumonia Syndrome. THE JOURNAL OF IMMUNOLOGY 2004; 173:1744-56. [PMID: 15265904 DOI: 10.4049/jimmunol.173.3.1744] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The pathogenesis of idiopathic pneumonia syndrome (IPS), a noninfectious pulmonary complication of allogeneic bone marrow transplantation (BMT), has not been fully elucidated. However, several contributing factors have been proposed, including lung injury caused by reactive oxygen and nitrogen intermediates during preconditioning and development of graft-vs-host disease (GVHD). Studies on the role of reactive oxygen and nitrogen intermediates in IPS have yielded conflicting results. We have described a murine model of IPS, in which the onset of lung inflammation was delayed by several weeks relative to GVHD. This study evaluated whether the delay in onset of IPS was due to slow turnover of NO-producing, immunosuppressive alveolar macrophages (AM) following BMT. The results indicated that AM were immunosuppressive due to synthesis of NO. However, NO production and immunosuppressive activity by AM did not decline after BMT, but rather remained elevated throughout the 12-wk development of GVHD and IPS. In a 14-day model of IPS, continuous inhibition of NO with aminoguanidine (AG) reduced signs of IPS/GVHD, but also led to higher mortality. When AG treatment was initiated after onset of IPS/GVHD, rapid mortality occurred that depended on the severity of IPS/GVHD. AG-enhanced mortality was not due to inhibition of marrow engraftment, elevated serum TNF-alpha, liver injury, or hypertensive responses. In contrast, T cells were involved, because depletion of CD4(+) lymphocytes 24 h before AG treatment prevented mortality. Thus, NO production following allogeneic BMT affords a protective effect that helps down-regulate injury caused by T cells during GVHD and IPS.
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Affiliation(s)
- David Hongo
- Department of Microbiology, Immunology, and Molecular Genetics, College of Medicine, University of Kentucky, Lexington, 40536, USA
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10
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Wang YG, Wagner MB, Kumar R, Goolsby WN, Joyner RW. Fast pacing facilitates discontinuous action potential propagation between rabbit atrial cells. Am J Physiol Heart Circ Physiol 2000; 279:H2095-103. [PMID: 11045942 DOI: 10.1152/ajpheart.2000.279.5.h2095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the critical coupling conductance (G(C)) for propagation at different pacing cycle lengths (CLs) (1,000 and 400 ms). As G(C) was progressively reduced, propagation failed at a CL of 1,000 ms, whereas propagation succeeded at a CL of 400 ms over a range of G(C) values before failing at a CL of 400 ms at a lower G(C), showing facilitation of propagation at the shorter CL. Critical G(C) was (means +/- SE) 0.8 +/- 0.1 nS for a CL of 400 ms and 1.3 +/- 0.1 nS for a CL of 1,000 ms (a 63% increase, P < 0.002, n = 9 cell pairs). In 14 uncoupled cells, action potential duration at 30% repolarization (APD(30)) increased from 19.9 +/- 2.5 to 41.8 +/- 2.6 ms (P < 0.001) as CL decreased from 1,000 to 400 ms. In five cell pairs, critical G(C) with 4-aminopyridine (4-AP) was reduced to 0.4 +/- 0.1 nS at a CL of 1,000 ms (P < 0.05 compared with control solution), and critical G(C) in 4-AP was unchanged by decreasing CL to 400 ms. It is possible that the "remodeling" of atrial cells due to atrial fibrillation or tachycardia, which has been shown to produce a decrease in the transient outward current, may result in an enhanced ability to propagate, possibly facilitating further development of fibrillation under conditions of decreased cellular coupling.
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Affiliation(s)
- Y G Wang
- Todd Franklin Cardiac Research Laboratory, Children's Heart Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Joyner RW, Wang YG, Wilders R, Golod DA, Wagner MB, Kumar R, Goolsby WN. A spontaneously active focus drives a model atrial sheet more easily than a model ventricular sheet. Am J Physiol Heart Circ Physiol 2000; 279:H752-63. [PMID: 10924075 DOI: 10.1152/ajpheart.2000.279.2.h752] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tachycardias can be produced when focal activity at ectopic locations in either the atria or the ventricles propagates into the surrounding quiescent myocardium. Isolated rabbit atrioventricular nodal cells were coupled by an electronic circuit to a real-time simulation of an array of cell models. We investigated the critical size of an automatic focus for the activation of two-dimensional arrays made up of either ventricular or atrial model cells. Over a range of coupling conductances for the arrays, the critical size of the focus cell group for successful propagation was smaller for activation of an atrial versus a ventricular array. Failure of activation of the arrays at smaller focus sizes was due to the inhibition of pacing of the nodal cells. At low levels of coupling conductance, the ventricular arrays required larger sizes of the focus due to failure of propagation even when the focus was spontaneously active. The major differences between activation of the atrial and ventricular arrays is due to the higher membrane resistance (lower inward rectifier current) of the atrial cells.
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Affiliation(s)
- R W Joyner
- Todd Franklin Cardiac Research Laboratory, The Children's Heart Center, Department of Pediatrics, Emory University, Atlanta, Georgia 30322, USA.
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12
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Huelsing DJ, Spitzer KW, Pollard AE. Electrotonic suppression of early afterdepolarizations in isolated rabbit Purkinje myocytes. Am J Physiol Heart Circ Physiol 2000; 279:H250-9. [PMID: 10899064 DOI: 10.1152/ajpheart.2000.279.1.h250] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many studies suggest that early afterdepolarizations (EADs) arising from Purkinje fibers initiate triggered arrhythmias under pathological conditions. However, electrotonic interactions between Purkinje and ventricular myocytes may either facilitate or suppress EAD formation at the Purkinje-ventricular interface. To determine conditions that facilitated or suppressed EADs during Purkinje-ventricular interactions, we coupled single Purkinje myocytes and aggregates isolated from rabbit hearts to a passive model cell via an electronic circuit with junctional resistance (R(j)). The model cell had input resistance (R(m,v)) of 50 M Omega, capacitance of 39 pF, and a variable rest potential (V(rest,v)). EADs were induced in Purkinje myocytes during superfusion with 1 microM isoproterenol. Coupling at high R(j) to normally polarized V(rest,v) established a repolarizing coupling current during all phases of the Purkinje action potential. This coupling current preferentially suppressed EADs in single cells with mean membrane resistance (R(m,p)) of 297 M Omega, whereas EAD suppression in larger aggregates with mean R(m,p) of 80 M Omega required larger coupling currents. In contrast, coupling to elevated V(rest,v) established a depolarizing coupling current during late phase 2, phase 3, and phase 4 that facilitated EAD formation and induced spontaneous activity in single Purkinje myocytes and aggregates. These results have important implications for arrhythmogenesis in the infarcted heart when reduction of the ventricular mass due to scarring alters the R(m,p)-to-R(m,v) ratio and in the ischemic heart when injury currents are established during coupling between polarized Purkinje myocytes and depolarized ventricular myocytes.
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Affiliation(s)
- D J Huelsing
- Cardiac Rhythm Management Laboratory and Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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Zaniboni M, Pollard AE, Yang L, Spitzer KW. Beat-to-beat repolarization variability in ventricular myocytes and its suppression by electrical coupling. Am J Physiol Heart Circ Physiol 2000; 278:H677-87. [PMID: 10710334 DOI: 10.1152/ajpheart.2000.278.3.h677] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Single ventricular myocytes paced at a constant rate and held at a constant temperature exhibit beat-to-beat variations in action potential duration (APD). In this study we sought to quantify this variability, assess its mechanism, and determine its responsiveness to electrotonic interactions with another myocyte. Interbeat APD(90) (90% repolarization) of single cells was normally distributed. We thus quantified APD(90) variability as the coefficient of variability, CV = (SD/mean APD(90)) x 100. The mean +/- SD of the CV in normal solution was 2.3 +/- 0.9 (132 cells). Extracellular TTX (13 microM) and intracellular EGTA (14 mM) both significantly reduced the CV by 44 and 26%, respectively. When applied in combination the CV fell by 54%. In contrast, inhibition of the rapid delayed rectifier current with L-691,121 (100 nM) increased the CV by 300%. The CV was also significantly reduced by 35% when two normal myocytes were electrically connected with a junctional resistance (R(j)) of 100 MOmega. Electrical coupling (R(j) = 100 MOmega) of a normal myocyte to one producing early afterdepolarization (EAD) completely blocked EAD formation. These results indicate that beat-to-beat APD variability is likely mediated by stochastic behavior of ion channels and that electrotonic interactions act to limit temporal dispersion of refractoriness, a major contributor to arrhythmogenesis.
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Affiliation(s)
- M Zaniboni
- Department of Evolutive and Functional Biology, University of Parma, Parma, Italy 43100
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