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Todd Franklin Cardiac Research Laboratory, Children's Heart Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322
We examined the critical coupling conductance (GC) for propagation at different pacing cycle lengths (CLs) (1,000 and 400 ms). As GC was progressively reduced, propagation failed at a CL of 1,000 ms, whereas propagation succeeded at a CL of 400 ms over a range of GC values before failing at a CL of 400 ms at a lower GC, showing facilitation of propagation at the shorter CL. Critical GC was (means ± SE) 0.8 ± 0.1 nS for a CL of 400 ms and 1.3 ± 0.1 nS for a CL of 1,000 ms (a 63% increase, P < 0.002, n = 9 cell pairs). In 14 uncoupled cells, action potential duration at 30% repolarization (APD30) increased from 19.9 ± 2.5 to 41.8 ± 2.6 ms (P < 0.001) as CL decreased from 1,000 to 400 ms. In five cell pairs, critical GC with 4-aminopyridine (4-AP) was reduced to 0.4 ± 0.1 nS at a CL of 1,000 ms (P < 0.05 compared with control solution), and critical GC in 4-AP was unchanged by decreasing CL to 400 ms. It is possible that the "remodeling" of atrial cells due to atrial fibrillation or tachycardia, which has been shown to produce a decrease in the transient outward current, may result in an enhanced ability to propagate, possibly facilitating further development of fibrillation under conditions of decreased cellular coupling.
electrophysiology; heart; arrhythmias
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