Inhibition of IK,ACh current may contribute to clinical efficacy of class i and class III antiarrhythmic drugs in patients with atrial fibrillation

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Niels Voigt - , Institute of Pharmacology and Toxicology (Author)
  • Nadiia Rozmaritsa - , Institute of Pharmacology and Toxicology (Author)
  • Anne Trausch - , Institute of Pharmacology and Toxicology (Author)
  • Thomasz Zimniak - , Institute of Pharmacology and Toxicology (Author)
  • Torsten Christ - , Institute of Pharmacology and Toxicology (Author)
  • Erich Wettwer - , Institute of Pharmacology and Toxicology (Author)
  • Klaus Matschke - , Department of Cardiac Surgery (at Dresden Heart Centre) (Author)
  • Dobromir Dobrev - , Institute of Pharmacology and Toxicology (Author)
  • Ursula Ravens - , Institute of Pharmacology and Toxicology (Author)

Abstract

Inward rectifier potassium currents IK1 and acetylcholine activated IK,ACh are implicated in atrial fibrillation (AF) pathophysiology. In chronic AF (cAF), IK,ACh develops a receptor-independent, constitutively active component that together with increased IK1 is considered to support maintenance of AF. Here, we tested whether class I (propafenone, flecainide) and class III (dofetilide, AVE0118) antiarrhythmic drugs inhibit atrial IK1 and I K,ACh in patients with and without cAF. IK1 and I K,ACh were measured with voltage clamp technique in atrial myocytes from 58 sinus rhythm (SR) and 35 cAF patients. The M-receptor agonist carbachol (CCh; 2∈μM) was employed to activate IK,ACh. In SR, basal current was not affected by either drug indicating no effect of these compounds on IK1. In contrast, all tested drugs inhibited CCh-activated I K,ACh in a concentration-dependent manner. In cAF, basal current was confirmed to be larger than in SR (at -80 mV, -15.2∈±∈1.2 pA/pF, n∈=∈88/35 vs. -6.5∈±∈0.4 pA/pF, n∈=∈194/58 [myocytes/patients]; P∈<∈0.05), whereas CCh-activated IK,ACh was smaller (-4.1∈±∈0.5 pA/pF vs. -9.5∈±∈0.6 pA/pF; P∈<∈0.05). In cAF, receptor-independent constitutive IK,ACh contributes to increased basal current, which was reduced by flecainide and AVE0118 only. This may be due to inhibition of constitutively active IK,ACh channels. In cAF, all tested drugs reduced CCh-activated IK,ACh. We conclude that in cAF, flecainide and AVE0118 reduce receptor-independent, constitutively active I K,ACh, suggesting that they may block IK,ACh channels, whereas propafenone and dofetilide likely inhibit M-receptors. The efficacy of flecainide to terminate AF may in part result from blockade of I K,ACh.

Details

Original languageEnglish
Pages (from-to)251-259
Number of pages9
JournalNaunyn-Schmiedeberg's archives of pharmacology
Volume381
Issue number3
Publication statusPublished - Mar 2010
Peer-reviewedYes

External IDs

PubMed 19760273

Keywords

ASJC Scopus subject areas

Keywords

  • Atrial fibrillation, AVE0118, Dofetilide, Flecainide, Potassium channels, Propafenone