Biomaterial Database

Proarrhythmic and antiarrhythmic actions of ion channel blockers on arrhythmias in the heart: model study. 1996

T R Chay

Department of Biological Sciences, University of Pittsburgh, Pennsylvania 15260, USA.

We explain why 1) some class I and IV antiarrhythmia drugs could exert proarrhythmic action, 2) some class III drugs are effective in controlling reentrant arrhythmias, and 3) cycle length (CL) oscillation is involved in the termination or initiation of reentry. To explain these phenomena, we employ the following three means: bifurcation analysis, simulation, and model construction. Antiarrhythmia drugs are modeled by varying maximal conductances of Na+, Ca2+, and time-dependent delayed rectifying and time-independent inward rectifying K+ channels in the Beeler-Reuter model, where the model cells are arranged in a ring. Bifurcation analysis predicts that there is a critical ring size (CRS) at which infinite ring behavior suddenly breaks down. Channel blockers can affect CRS in different manners: Na+ and Ca2+ blockers shorten CRS, whereas delayed rectifying K+ channel blockers and the inward K+ channel blockers lengthen CRS. This differential explains why some antiarrhythmia drugs are proarrhythmic (i.e., shorten CRS) whereas others are antiarrhythmic (i.e., lengthen CRS). Simulation is then used to investigate how the drugs affect reentrant rhythms in the neighborhood of the CRS. We find that, in this region, CL, conduction velocity, and action potential duration become oscillatory. As ring size shrinks, the pattern of the oscillation becomes more complex. When the ring shrinks to a certain size, reentry can no longer be sustained, and it terminates after a few oscillatory cycles. To explain the basic mechanism involved in CL oscillation, we then construct a minimal model that contains a low-threshold fast inward current and a high-threshold slow inward current. With this model, we show that the two inward currents, with vastly different activation and inactivation kinetics, cause CL oscillations. Our results thus give theoretical explanations for the experimental finding of Frame's group in canine atrial tricuspid ring in vitro that class IC drugs can bring about stable reentry from nonsustained transient reentry, whereas class III drugs transform stable reentry to complex oscillations in CL. Our results also support the result of Frame's group, in that, in "adjustable" tricuspid rings, CL oscillation becomes more complex and its period becomes shorter as an excitable gap is shortened.

UI	MeSH Term	Description	Entries
D007473	Ion Channels	Gated, ion-selective glycoproteins that traverse membranes. The stimulus for ION CHANNEL GATING can be due to a variety of stimuli such as LIGANDS, a TRANSMEMBRANE POTENTIAL DIFFERENCE, mechanical deformation or through INTRACELLULAR SIGNALING PEPTIDES AND PROTEINS.	Membrane Channels,Ion Channel,Ionic Channel,Ionic Channels,Membrane Channel,Channel, Ion,Channel, Ionic,Channel, Membrane,Channels, Ion,Channels, Ionic,Channels, Membrane
D008955	Models, Cardiovascular	Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.	Cardiovascular Model,Cardiovascular Models,Model, Cardiovascular
D003198	Computer Simulation	Computer-based representation of physical systems and phenomena such as chemical processes.	Computational Modeling,Computational Modelling,Computer Models,In silico Modeling,In silico Models,In silico Simulation,Models, Computer,Computerized Models,Computer Model,Computer Simulations,Computerized Model,In silico Model,Model, Computer,Model, Computerized,Model, In silico,Modeling, Computational,Modeling, In silico,Modelling, Computational,Simulation, Computer,Simulation, In silico,Simulations, Computer
D006321	Heart	The hollow, muscular organ that maintains the circulation of the blood.	Hearts
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D000889	Anti-Arrhythmia Agents	Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.	Anti-Arrhythmia Agent,Anti-Arrhythmia Drug,Anti-Arrhythmic,Antiarrhythmia Agent,Antiarrhythmia Drug,Antiarrhythmic Drug,Antifibrillatory Agent,Antifibrillatory Agents,Cardiac Depressant,Cardiac Depressants,Myocardial Depressant,Myocardial Depressants,Anti-Arrhythmia Drugs,Anti-Arrhythmics,Antiarrhythmia Agents,Antiarrhythmia Drugs,Antiarrhythmic Drugs,Agent, Anti-Arrhythmia,Agent, Antiarrhythmia,Agent, Antifibrillatory,Agents, Anti-Arrhythmia,Agents, Antiarrhythmia,Agents, Antifibrillatory,Anti Arrhythmia Agent,Anti Arrhythmia Agents,Anti Arrhythmia Drug,Anti Arrhythmia Drugs,Anti Arrhythmic,Anti Arrhythmics,Depressant, Cardiac,Depressant, Myocardial,Depressants, Cardiac,Depressants, Myocardial,Drug, Anti-Arrhythmia,Drug, Antiarrhythmia,Drug, Antiarrhythmic,Drugs, Anti-Arrhythmia,Drugs, Antiarrhythmia,Drugs, Antiarrhythmic
D001145	Arrhythmias, Cardiac	Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.	Arrhythmia,Arrythmia,Cardiac Arrhythmia,Cardiac Arrhythmias,Cardiac Dysrhythmia,Arrhythmia, Cardiac,Dysrhythmia, Cardiac