Pharmacologically induced long QT type 2 can be rescued by activation of IKs with benzodiazepine R-L3 in isolated guinea pig cardiomyocytes

J Cardiovasc Pharmacol. 2009 Aug;54(2):169-77. doi: 10.1097/FJC.0b013e3181af6db3.

Abstract

The ionic current responsible for terminating the action potential (AP), and thereby in part determining the AP duration (APD), is the potassium current (IK), consisting of primarily two components: a rapidly (IKr) and a slowly (IKs) activating delayed rectifier potassium current. The aim of this study was to evaluate potential antiarrhythmic effects of compound induced IKs activation using the benzodiazepine L-364,373 (R-L3). Ventricular myocytes from guinea pigs were isolated and whole-cell current clamping was performed at 35 degrees C. It was found that 1 microM R-L3 significantly reduced the APD90 at pacing frequencies of 1, 2, and 4 Hz when compared to control (40 +/- 6%, 22 +/- 2%, and 32 +/- 2%, respectively). The reduction of APD90 was accompanied by a reduced triangulation (given as APD30-90) when compared to control at all pacing frequencies (62 +/- 7 ms vs. 41 +/- 3 ms, 55 +/- 5 ms vs. 35 +/- 6 ms, and 45 +/- 4 ms vs. 32 +/- 2 ms, at 1 Hz, 2 Hz, and 4 Hz, respectively). The abbreviated APDs also resulted in a reduction in the relative refractory period, and no direct protection against pacing induced early after-depolarizations (EAD) could be observed. However, an increase in repolarizing capacity was seen with 1 microM R-L3, as more complete repolarization of the AP was achieved before EADs could be elicited. Finally, a functional demonstration of the repolarization reserve revealed that increased IKs can counteract a pharmacologically reduced IKr. In conclusion, pharmacological activation of IKs possesses both pro- and antiarrhythmic characters. The most prominent antiarrhythmic propensity is the ability for IKs activation to rescue a cellular model of long QT type 2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / pharmacology*
  • Benzodiazepines / pharmacology*
  • Delayed Rectifier Potassium Channels / drug effects
  • Delayed Rectifier Potassium Channels / metabolism
  • Disease Models, Animal
  • Electrocardiography
  • Electrophysiology
  • Female
  • Guinea Pigs
  • Heart Ventricles / metabolism
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / drug therapy*
  • Long QT Syndrome / physiopathology
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / metabolism

Substances

  • Anti-Arrhythmia Agents
  • Delayed Rectifier Potassium Channels
  • L 364373
  • Benzodiazepines