Europace Advance Access originally published online on January 25, 2007
Europace 2007 9(3):154-161; doi:10.1093/europace/eul146
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VENTRICULAR ARRHYTHMIA
Role of KATP channels in repetitive induction of ventricular fibrillation
1 Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany; 2 Department of Medical Biometry and Informatics, University of Heidelberg, Germany
Aim Patients with sustained ventricular tachyarrhythmias are at high risk for sudden cardiac death. The mechanisms leading to multiple temporally related episodes of ventricular fibrillation (VF) are not yet fully elucidated, and treatment options are limited. We investigated whether KATP-channels could be involved in triggering VF.
Methods We determined postarrhythmic changes of monophasic action potentials (MAP) after repetitive induction of VF in 32 Langendorff-perfused rabbit hearts.
Results Postarrhythmic action potential duration (APD) was significantly shorter compared with baseline (100 ± 12 ms vs. 140 ± 8 ms, P < 0.05). With increasing numbers of VF and shortening of recovery intervals between VF episodes (2 min) inducibility of VF increased, and abbreviation of APD became more prominent (90 ± 5 ms vs. 130 ± 4 ms, P < 0.05). Pre-treatment with the selective KATP blocking agent HMR 1883 led to a significant increase of postarrhythmic APDs compared with control hearts (100 ± 12 ms vs. 118 ± 3 ms, P = 0.0013). Moreover, HMR 1883 significantly reduced inducibility of VF and increased the rate of successful defibrillation.
Conclusions Repetitive episodes of VF result in postarrhythmic abbreviation of APDs, a phenomenon thought to be of potential relevance for incessant tachyarrhythmias in patients. Prevention of postarrhythmic MAP-shortening by HMR 1883 might be useful in suppressing VF.
Key Words: KATP channels, HMR 1883, ventricular fibrillation, arrhythmias
* Corresponding author. Tel: +49 6221 5638672; fax: +49 6221 565514. E-mail address: alexander_bauer{at}med.uni-heidelberg.de
These authors contributed equally to this work.
Manuscript submitted 12 April 2006. Accepted after revision 2 October 2006.
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