Chronic atrial fibrillation (AF) is associated with shortening of action potential duration (APD), which involves modified activity of atrial ion currents. However, little is known about the activity of ATP-sensitive K + channels ( I K,ATP) during chronic AF. An AF-related increase in the activity of I K,ATP would reduce APD and could contribute to initiation and/or perpetuation of AF. Here, we studied the activity of I K,ATP in atrial myocytes from patients with sinus rhythm (SR) and chronic AF. Human atrial myocytes were isolated from atrial tissue obtained from patients undergoing open-heart surgery. Inward rectifier currents were measured with the whole-cell patch-clamp technique by applying a depolarizing ramp pulse (1245 ms) from –100 to +40 mV (0.5 Hz). I K,ATP was activated with the I K,ATP channel opener rilmakalim. The inward rectifier I K1 and I K,ATP were identified by their sensitivity to 1 mM Ba 2+. Density of I K1 did not differ between cells from patients with AF (at –100 mV: –14.8 ± 1.3 pA/pF, n = 38/10 (cells/patients)) and SR (–13.8 ± 1.5 pA/pF, n = 33/16). In both types of cells, rilmakalim stimulated I K,ATP (defined as rilmakalim-inducible current) in a concentration-dependent manner (0.3–10 μM). However, maximum activation of I K,ATP with 10 μM rilmakalim was smaller in AF than in SR cells (at –100 mV: –5.3 ± 0.8 pA/pF, n = 22/7 vs. –11.2 ± 2.9 pA/pF, n = 19/9; at +40 mV: +9.6 ± 2.1 pA/pF, n = 22/7 vs. +23.7 ± 3.4 pA/pF, n = 19/9 for AF and SR, respectively; P < 0.05). Only aortic valve disease and pulmonary hypertension were found to be independent contributors to I K,ATP current density. We provide evidence that chronic AF is associated with a downregulation of ATP-sensitive K + currents. These changes may provide an additional molecular mechanism for electrical remodeling in chronic AF.
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