Repolarization abnormalities and afterdepolarizations in a canine model of sudden cardiac death

Am J Physiol Regul Integr Comp Physiol. 2008 Nov;295(5):R1463-72. doi: 10.1152/ajpregu.90583.2008. Epub 2008 Sep 3.

Abstract

Ventricular tachyarrhythmias are the most common cause of sudden cardiac death (SCD); a healed myocardial infarction increases the risk of SCD. We determined the contribution of specific repolarization abnormalities to ventricular tachyarrhythmias in a postinfarction model of SCD. For our methods, we used a postinfarction canine model of SCD, where an exercise and ischemia test was used to stratify animals as either susceptible (VF(+)) or resistant (VF(-)) to sustained ventricular tachyarrhythmias. Our results show no changes in global left ventricular contractility or volumes occurred after infarction. At 8-10 wk postmyocardial infarction, myocytes were isolated from the left ventricular midmyocardial wall and studied. In the VF(+) animals, myocyte action potential (AP) prolongation occurred at 50 and 90% repolarization (P < 0.05) and was associated with increased variability of AP duration and afterdepolarizations. Multiple repolarizing K(+) currents (I(Kr), I(to)) and inward I(K1) were also reduced (P < 0.05) in myocytes from VF(+) animals compared with control, noninfarcted dogs. In contrast, only I(to) was reduced in VF(-) myocytes compared with controls (P < 0.05). While afterdepolarizations were not elicited at baseline in myocytes from VF(-) animals, afterdepolarizations were consistently elicited after the addition of an I(Kr) blocker. In conclusion, the loss of repolarization reserve via reductions in multiple repolarizing currents in the VF(+) myocytes leads to AP prolongation, repolarization instability, and afterdepolarizations in myocytes from animals susceptible to SCD. These abnormalities may provide a substrate for initiation of postmyocardial infarction ventricular tachyarrhythmias.

Publication types

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

MeSH terms

  • 4-Aminopyridine / pharmacology
  • Action Potentials / physiology
  • Animals
  • Cell Separation
  • Death, Sudden, Cardiac / pathology*
  • Dogs
  • Down-Regulation / drug effects
  • Electrocardiography
  • Electrophysiology
  • Female
  • In Vitro Techniques
  • Male
  • Myocardial Infarction / physiopathology*
  • Myocytes, Cardiac / pathology
  • Myocytes, Cardiac / physiology
  • Potassium Channel Blockers / pharmacology
  • Potassium Channels / biosynthesis
  • Potassium Channels / drug effects
  • Tachycardia, Ventricular / physiopathology*

Substances

  • Potassium Channel Blockers
  • Potassium Channels
  • 4-Aminopyridine