Abstract
Introduction : An important role for the inwardly rectifying potassium current (I K1 ) has been postulated in controlling the stability and frequency of rotors responsible for ventricular tachycardia and fibrillation. We investigated the effects of Kir2.1 overexpression and Kir2.1AAA dominant-negative mutant suppression on the electrophysiology and inducibility, stability and frequency of spiral waves in an in vitro cardiac tissue model. Methods/Results : Neonatal rat ventricular myocytes (NRVMs) were transduced by lentiviral vectors encoding Kir2.1 or Kir2.1AAA. Immunostaining revealed Kir2.1 or mutant Kir2.1 protein overexpression and whole cell-clamp confirmed the predicted effects on I K1 , resting potential, and action potential duration (APD 80 ). Optical mapping was performed on confluent NRVM monolayers containing a 5 mm diameter central island of gene-modified NRVMs created by a stenciling technique. APs propagated with increased CV (25.1±2.7 cm/sec, n=7) and shortened APD 80 (73±11 msec, n=7) in islands of Kir2.1 overexpression, or decreased CV (13.1±1.1 cm/sec, n=7) and prolonged APD 80 (263±14 msec, n=7) in islands of Kir2.1AAA suppression, compared with normal CV and APD 80 of 19.2±0.4 cm/sec and 169±14 msec (n=7) in non-transduced islands. Reentry was initiated by rapid pacing. With Kir2.1 overexpression, reentrant waves anchored to the island and remained stable (89±15 minutes, n=3) with a frequency of 8±2 Hz. Superfusion with 0.5 mM BaCl 2 to block I K1 slowed reentry to 1 Hz and terminated it shortly after initiation. NRVM monolayers with islands of Kir2.1AAA suppression (n=3) displayed rapid spontaneous activity. Rapid pacing of these monolayers initiated an unstable figure-of-eight reentry (n=3) that degraded into single and multi-armed spiral waves, anchored to varying parts of the island with a maximum frequency of 2±1 Hz. Importantly, no reentry could be initiated in monolayers with non-transduced islands (n=3). Conclusion : Functional reentrant waves induced by rapid pacing are anchored to islands of localized Kir2.1 overexpression whereas they drop in frequency and meander in islands of dominant-negative suppression of Kir2.1, confirming the importance of I K1 for the stability of these waves in cardiac tissue.
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