Atrial-selective prolongation of refractory period with AVE0118 is due principally to inhibition of sodium channel activity
Open accessAbstract
The action of AVE0118 to prolong effective refractory period (ERP) in atria but not in ventricles is thought to be due to its inhibition of IKur. However, in nonremodeled atria, AVE0118 prolongs ERP but not action potential duration (APD70-90), which can be explained with the inhibition of sodium but not potassium channel current. ERP, APD, and the maximum rate of increase of the AP upstroke (Vmax) were measured in the canine-isolated coronary-perfused right atrial and in superfused ventricular tissue preparations. Whole-cell patch-clamp techniques were used to measure sodium channel current in HEK293 cells stably expressing SCN5A. AVE0118 (5-10 μM) prolonged ERP (P < 0.001) but not APD70 and decreased Vmax (by 15%, 10 μM, P < 0.05; n = 10 for each). Ventricular ERP, APD90, and Vmax were not changed significantly by 10 μM AVE0118 (all P = ns; n = 7). AVE0118 effectively suppressed acetylcholine-mediated persistent atrial fibrillation. AVE0118 (10 μM) reduced peak current amplitude of SCN5A-WT current by 36.5% ± 6.6% (P < 0.01; n = 7) and shifted half-inactivation voltage (V0.5) of the steady-state inactivation curve from -89.9 ± 0.5 to -96.0 ± 0.9 mV (P < 0.01; n = 7). Our data suggest that AVE0118-induced prolongation of atrial, but not ventricular ERP, is due largely to atrial-selective depression of sodium channel current, which likely contributes to the effectiveness of AVE0118 to suppress atrial fibrillation.
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Several compounds that inhibit the ultrarapid potassium current (IKur) and other inhibitors of atypical ion channels are in clinical development.
“Several compounds that inhibit the ultrarapid potassium current (I Kur ) and other inhibitors of atypical ion channels are in clinical development.[673][674][675]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [673]
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
- Authors
- Burashnikov, A., Barajas-Martinez, H., Hu, D., Nof, E., Blazek, J., & Antzelevitch, C.
- Affiliations
- Masonic Medical Research Laboratory (US)
- Venue
- Journal of Cardiovascular Pharmacology
- Published
- 2012-06
- Volume
- 59
- Issue
- 6
- Pages
- 539-546
- ISSN
- 0160-2446 (ISSN-L)
- PMC
- PMC3369013
- OpenAlex
- W2068541942
- Cited by
- 25
- References
- 47
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1 · 2016: 5 · 2015: 2 · 2014: 7
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Cardiovascular Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL047678)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion channel regulation and function
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- effective refractory period, atrial fibrillation, IKur, sodium current, SCN5A, action potential upstroke velocity, atrial electrophysiology, antiarrhythmic drugs
- MeSH terms
- Acetylcholine, Action Potentials, Animals, Atrial Fibrillation, Biphenyl Compounds, Dogs, Dose-Response Relationship, Drug, Heart Atria, Humans, Refractory Period, Electrophysiological, Potassium Channels, Sodium Channels, Patch-Clamp Techniques, Potassium Channel Blockers, Sodium Channel Blockers, HEK293 Cells
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