Shaping a new Ca²⁺ conductance to suppress early afterdepolarizations in cardiac myocytes

J Physiol. 2011 Dec 15;589(Pt 24):6081-92. doi: 10.1113/jphysiol.2011.219600. Epub 2011 Oct 24.

Abstract

Sudden cardiac death (SCD) due to ventricular fibrillation (VF) is a major world-wide health problem. A common trigger of VF involves abnormal repolarization of the cardiac action potential causing early afterdepolarizations (EADs). Here we used a hybrid biological-computational approach to investigate the dependence of EADs on the biophysical properties of the L-type Ca(2+) current (I(Ca,L)) and to explore how modifications of these properties could be designed to suppress EADs. EADs were induced in isolated rabbit ventricular myocytes by exposure to 600 μmol l(-1) H(2)O(2) (oxidative stress) or lowering the external [K(+)] from 5.4 to 2.0-2.7 mmol l(-1) (hypokalaemia). The role of I(Ca,L) in EAD formation was directly assessed using the dynamic clamp technique: the paced myocyte's V(m) was input to a myocyte model with tunable biophysical parameters, which computed a virtual I(Ca,L), which was injected into the myocyte in real time. This virtual current replaced the endogenous I(Ca,L), which was suppressed with nifedipine. Injecting a current with the biophysical properties of the native I(Ca,L) restored EAD occurrence in myocytes challenged by H(2)O(2) or hypokalaemia. A mere 5 mV depolarizing shift in the voltage dependence of activation or a hyperpolarizing shift in the steady-state inactivation curve completely abolished EADs in myocytes while maintaining a normal Ca(i) transient. We propose that modifying the biophysical properties of I(Ca,L) has potential as a powerful therapeutic strategy for suppressing EADs and EAD-mediated arrhythmias.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials / drug effects
  • Action Potentials / physiology*
  • Animals
  • Arrhythmias, Cardiac / physiopathology*
  • Calcium / physiology*
  • Calcium Channel Blockers / pharmacology
  • Hydrogen Peroxide / pharmacology
  • Hypokalemia / physiopathology
  • Myocytes, Cardiac / physiology*
  • Nifedipine / pharmacology
  • Oxidants / pharmacology
  • Oxidative Stress
  • Patch-Clamp Techniques
  • Rabbits

Substances

  • Calcium Channel Blockers
  • Oxidants
  • Hydrogen Peroxide
  • Nifedipine
  • Calcium