Inhibition of IK,ACh current may contribute to clinical efficacy of class i and class III antiarrhythmic drugs in patients with atrial fibrillation
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Contributors
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 language | English |
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Pages (from-to) | 251-259 |
Number of pages | 9 |
Journal | Naunyn-Schmiedeberg's archives of pharmacology |
Volume | 381 |
Issue number | 3 |
Publication status | Published - Mar 2010 |
Peer-reviewed | Yes |
External IDs
PubMed | 19760273 |
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Keywords
ASJC Scopus subject areas
Keywords
- Atrial fibrillation, AVE0118, Dofetilide, Flecainide, Potassium channels, Propafenone