Ivabradine causes abnormal intracellular calcium handlings and delayed
afterdepolarizations to induce atrial fibrillation in rabbit hearts
Abstract
Objective: The present paper is to determine the effects and underlying
mechanisms of ivabradine (IVA) on atrial fibrillation (AF). Methods:
Electrophysiological changes were determined using Langendorff-perfused
hearts and patch-clamp techniques. Parameters of Ca2+
handling were evaluated by using calcium imaging and western blotting.
Results: IVA (0.1-10 μM) slowed HR in a concentration-dependent manner
in isolated hearts of rabbit. IVA induced atrial arrhythmias in 26.1%
and 76.9% of hearts paced at a basic cycle length of 350 and 570 ms,
respectively. In hearts pretreated with either acetylcholine (ACh) or
anemone toxin-II (ATX-II) which caused no inducible atrial arrhythmias,
adding to IVA administration caused atrial arrhythmias in 61.9% (13/21)
and 44.4% (8/18) of hearts, respectively. In atrial myocytes, IVA
induced DADs by 41.7%, 62.5% and 50.0%, respectively, in the absence
and presence of either ACh or ATX-II. IVA increased the frequency,
amplitude and full width at half-maximum (FWHM) of
Ca2+ sparks and decreased Ca2+
transport in association with increased protein expression of RyR2 and
NCX1 and decreased SERCA2. Conclusion: IVA increases atrial
proarrhythmic risk in hearts with a slow HR, enhanced vagal tone and
increased late sodium current by inducing DADs resulting from an
enhanced intracellular Ca2+ inhomeostasis.