Title: Knock-in gain-of-function sodium channel mutation prolongs atrial action potentials and alters atrial vulnerability
Authors: Blana, Andreas
Kaese, Sven
Fortmüller, Lisa
Laakmann, Sandra
Damke, Dierk
Bragt, Kelly van
Eckstein, Jens
Piccini, Ilaria
Kirchhefer, Uwe
Nattel, Stanley
Breithardt, Günter
Carmeliet, Peter
Carmeliet, Edward
Schotten, Ulrich
Verheule, Sander
Kirchhof, Paulus
Fabritz, Larissa # ×
Issue Date: Dec-2010
Publisher: Elsevier
Series Title: Heart Rhythm vol:7 issue:12 pages:1862-1869
Abstract: BACKGROUND: Patients with long QT syndrome (LQTS) are at increased risk not only for ventricular arrhythmias but also for atrial pathology including atrial fibrillation (AF). Some patients with "lone" AF carry Na(+)-channel mutations. OBJECTIVE: The purpose of this study was to determine the mechanisms underlying atrial pathology in LQTS. METHODS: In mice with a heterozygous knock-in long QT syndrome type 3 (LQT3) mutant of the cardiac Na(+) channel (ΔKPQ-SCN5A) and wild-type (WT) littermates, atrial size, function, and electrophysiologic parameters were measured in intact Langendorff-perfused hearts, and histologic analysis was performed. RESULTS: Atrial action potential duration, effective refractory period, cycle length, and PQ interval were prolonged in ΔKPQ-SCN5A hearts (all P <.05). Flecainide (1 μM) reversed atrial action potential duration prolongation and induced postrepolarization refractoriness (P <.05). Arrhythmias were infrequent during regular rapid atrial rate in both WT and ΔKPQ-SCN5A but were inducible in 15 (38%) of 40 ΔKPQ-SCN5A and 8 (29%) of 28 WT mice upon extrastimulation. Pacing protocols generating rapid alterations in rate provoked atrial extrasystoles and arrhythmias in 6 (66%) of 9 ΔKPQ-SCN5A but in 0 (0%) of 6 WT mice (P <.05). Atrial diameter was increased by nearly 10% in ΔKPQ-SCN5A mice >5 months old without increase in fibrotic tissue. CONCLUSION: Murine hearts bearing an LQT3 mutation show abnormalities in atrial electrophysiology and subtle changes in atrial dimension, including an atrial arrhythmogenic phenotype on provocation. These results support clinical data suggesting that LQTS mutations can cause atrial pathology and arrhythmogenesis and indicate that murine sodium channel LQTS models may be useful for exploring underlying mechanisms.
ISSN: 1547-5271
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Vesalius Research Centre (-)
Laboratory of Angiogenesis and Vascular Metabolism (Vesalius Research Center) (+)
× corresponding author
# (joint) last author

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