Revisiting the ionic mechanisms of early afterdepolarizations in cardiomyocytes: predominant by Ca waves or Ca currents?

Am J Physiol Heart Circ Physiol. 2012 Apr 15;302(8):H1636-44. doi: 10.1152/ajpheart.00742.2011. Epub 2012 Feb 3.

Abstract

Early afterdepolarizations (EADs) have been implicated in severe cardiac arrhythmias and sudden cardiac deaths. However, the mechanism(s) for EAD genesis, especially regarding the relative contribution of Ca(2+) wave (CaW) vs. L-type Ca current (I(Ca,L)), still remains controversial. In the present study, we simultaneously recorded action potentials (APs) and intracellular Ca(2+) images in isolated rabbit ventricular myocytes and systematically compared the properties of EADs in the following two pharmacological models: 1) hydrogen peroxide (H(2)O(2); 200 μM); and 2) isoproterenol (100 nM) and BayK 8644 (50 nM) (Iso + BayK). We assessed the rate dependency of EADs, the temporal relationship between EADs and corresponding CaWs, the distribution of EADs over voltage, and the effects of blockers of I(Ca,L), Na/Ca exchangers, and ryanodine receptors. The most convincing evidence came from the AP-clamp experiment, in which the cell membrane clamp was switched from current clamp to voltage clamp using a normal AP waveform without EAD; CaWs disappeared in the H(2)O(2) model, but persisted in the Iso + BayK model. We postulate that, although CaWs and reactivation of I(Ca,L) may act synergistically in either case, reactivation of I(Ca,L) plays a predominant role in EAD genesis under oxidative stress (H(2)O(2) model), while spontaneous CaWs are a predominant cause for EADs under Ca(2+) overload condition (Iso + BayK model).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Action Potentials / drug effects
  • Adrenergic beta-Agonists / pharmacology
  • Aniline Compounds / pharmacology
  • Animals
  • Calcium Channel Agonists / pharmacology
  • Calcium Channel Blockers / pharmacology
  • Calcium Channels / physiology*
  • Calcium Signaling / physiology*
  • Electrophysiological Phenomena / physiology
  • Heart Ventricles
  • Homeodomain Proteins
  • Hydrogen Peroxide / pharmacology
  • In Vitro Techniques
  • Isoproterenol / pharmacology
  • Kinetics
  • Myocytes, Cardiac / physiology*
  • Patch-Clamp Techniques
  • Phenyl Ethers / pharmacology
  • Rabbits
  • Ryanodine / pharmacology
  • Ryanodine Receptor Calcium Release Channel / drug effects
  • Sarcoplasmic Reticulum / drug effects
  • Sarcoplasmic Reticulum / physiology
  • Sodium-Calcium Exchanger / antagonists & inhibitors

Substances

  • Adrenergic beta-Agonists
  • Aniline Compounds
  • Calcium Channel Agonists
  • Calcium Channel Blockers
  • Calcium Channels
  • Homeodomain Proteins
  • Phenyl Ethers
  • Ryanodine Receptor Calcium Release Channel
  • SEA 0400
  • Sodium-Calcium Exchanger
  • TLX2 protein, human
  • Ryanodine
  • Hydrogen Peroxide
  • Isoproterenol