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Rhode Island Hospital studies uncover keys in sudden cardiac death
Date:1/17/2012

Journal of Physiology, the researchers used this animal model to identify differential conditions and cellular mechanisms that trigger arrhythmia in LQT1 or in LQT2 syndrome. In this study, Koren and the researchers studied early afterdepolarizations (EADs), an abnormal depolarization during the plateau phase of the heart electrical activity (action potential) that can initiate arrhythmia, and a hallmark of LQTS. The focus was on mechanisms underlying different high-risk conditions that trigger EADs.

Their findings indicate that the conditions required for EAD to occur in the animal models are genotype specific. For LQT2, the researchers found that conditions such as a slow heart rate or a slightly lower potassium ion concentration outside the heart cells (as seen in hypokalemia) can cause a dramatic prolongation of action potential and produce triggered activity (EADs). In LQT1, however, these conditions result in relatively limited prolongation and no EADs. In contrast, isoproterenol that mimics cardiac stimulation by the sympathetic system causes arrhythmias in single cells only in LQT1 heart cells.

Koren summarizes, "This study takes single cells out of the heart and reveals how arrhythmias are being initiated. What we are showing in this study is that single cells are responsible for generating an arrhythmia. Further, we found that different types of increased autonomic nervous system activity play a critical role in the cause of arrhythmias and sudden cardiac death, but it differs based on genotype."

The autonomic nervous system is what controls "fight or flight" response. In their research, Koren and his colleagues found that sympathetic "surge" activity was responsible for triggering arrhythmia in LQT2. In LQT1, however, an increased steady sympathetic tone was associated with arrhythmias.

Surge is a sudden rise of the sympathetic tone. That surge is very important in triggering arrhythmia in LQT2. As Koren explains, "I
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Contact: Nancy Jean
njean@lifespan.org
Lifespan
Source:Eurekalert  

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