Abrupt rate accelerations or premature beats cause life-threatening arrhythmias in mice with long-QT3 syndrome

D Nuyens, M Stengl, S Dugarmaa, T Rossenbacker… - Nature medicine, 2001 - nature.com
D Nuyens, M Stengl, S Dugarmaa, T Rossenbacker, V Compernolle, Y Rudy, JF Smits…
Nature medicine, 2001nature.com
Deletion of amino-acid residues 1505–1507 (KPQ) in the cardiac SCN5A Na+ channel
causes autosomal dominant prolongation of the electrocardiographic QT interval (long-QT
syndrome type 3 or LQT3). Excessive prolongation of the action potential at low heart rates
predisposes individuals with LQT3 to fatal arrhythmias, typically at rest or during sleep. Here
we report that mice heterozygous for a knock-in KPQ-deletion (SCN5AΔ/+) show the
essential LQT3 features and spontaneously develop life-threatening polymorphous …
Abstract
Deletion of amino-acid residues 1505–1507 (KPQ) in the cardiac SCN5A Na+ channel causes autosomal dominant prolongation of the electrocardiographic QT interval (long-QT syndrome type 3 or LQT3). Excessive prolongation of the action potential at low heart rates predisposes individuals with LQT3 to fatal arrhythmias, typically at rest or during sleep. Here we report that mice heterozygous for a knock-in KPQ-deletion (SCN5AΔ/+) show the essential LQT3 features and spontaneously develop life-threatening polymorphous ventricular arrhythmias. Unexpectedly, sudden accelerations in heart rate or premature beats caused lengthening of the action potential with early afterdepolarization and triggered arrhythmias in Scn5aΔ/+ mice. Adrenergic agonists normalized the response to rate acceleration in vitro and suppressed arrhythmias upon premature stimulation in vivo. These results show the possible risk of sudden heart-rate accelerations. The Scn5aΔ/+ mouse with its predisposition for pacing-induced arrhythmia might be useful for the development of new treatments for the LQT3 syndrome.
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